A Cadaveric Study of Occurrence of Extralaryngeal Branches of the Recurrent Laryngeal Nerve with Reference to its Importance in Thyroid Surgery

Introduction Recurrent Laryngeal Nerve Palsy (RLNP) is the most common complication of thyroid surgery. Patients complain of hoarseness of voice and sometimes variable amount of respiratory distress due to palsy of recurrent laryngeal nerve (RLN), extra laryngeal branches of which are often ligated along with Inferior Thyroid Artery (ITA) during thyroidectomy. So prevalence and variable pattern of extra laryngeal nerve branches (ELNB) of RLN should be known to the thyroid surgeon to avoid post operative complications. Materials and Methods   Dissection was carried on the neck of properly embalmed 25 adult cadavers including both sexes in the dissection hall to study extra laryngeal nerve branches (ELNB) of 50 RLN specimens. Results Out of 50 RLN, 13 nerves (26%) have ELNBs. Only in 4 cadavers (16%) they are bilateral. In 9 cases RLN branches were surrounding either single trunk of ITA or branches of the artery. In rest of the 4 cases ELNBs were passing entirely either in front or behind the ITA Conclusion The gold standard for preservation of the RLN during thyroid surgery is still visual anatomical identification. Proper dissection and anatomical identification of the RLN and all its branches is very important prior to the clamping of the ITA and all its branches

Cross Sectional Study on Thyroid Arteries with Clinical Correlations

Introduction- Thyroid gland is a highly vascular endocrine gland. The aim of our study is to explore thyroid arteries to escape eventual iatrogenic complications. Materials and Methods- Both sides of neck of total 60 adult embalmed cadavers were dissected in West Bengal (2020-2021). Results- We found Superior Thyroid Arteries in 100% cases originating from External Carotid Artery in 77.5% cases, Carotid Bifurcation in 11.67% cases, Common Carotid Artery in 7.5% cases, as well as a common trunk with Lingual artery in 1.67% cases, Lingual and Facial arteries in 1.67% cases. Source of origin of Superior Thyroid Artery when compared with level of origin and between male and female cadavers, the result was found statistically significant (p< 0.05). Inferior Thyroid Artery was present in 90% cases and absent in 10% cases. Inferior Thyroid Artery originated from Thyrocervical Trunk in 92.5% cases, Common Carotid Artery in 1.67% cases, Subclavian Artery in 0.83% cases. Thyroidea Ima Artery was found in 3.33% cases arising from Arch of Aorta and Brachiocephalic Trunk. Conclusion- Knowledge of thyroid arterial variations will help to prevent loss of patient life due to hemorrhage during surgery

A Cadaveric Study of Occurrence of Extralaryngeal Branches of the Recurrent Laryngeal Nerve with Reference to its Importance in Thyroid Surgery

Introduction Recurrent Laryngeal Nerve Palsy (RLNP) is the most common complication of thyroid surgery. Patients complain of hoarseness of voice and sometimes variable amount of respiratory distress due to palsy of recurrent laryngeal nerve (RLN), extra laryngeal branches of which are often ligated along with Inferior Thyroid Artery (ITA) during thyroidectomy. So prevalence and variable pattern of extra laryngeal nerve branches (ELNB) of RLN should be known to the thyroid surgeon to avoid post operative complications. Materials and Methods   Dissection was carried on the neck of properly embalmed 25 adult cadavers including both sexes in the dissection hall to study extra laryngeal nerve branches (ELNB) of 50 RLN specimens. Results Out of 50 RLN, 13 nerves (26%) have ELNBs. Only in 4 cadavers (16%) they are bilateral. In 9 cases RLN branches were surrounding either single trunk of ITA or branches of the artery. In rest of the 4 cases ELNBs were passing entirely either in front or behind the ITA Conclusion The gold standard for preservation of the RLN during thyroid surgery is still visual anatomical identification. Proper dissection and anatomical identification of the RLN and all its branches is very important prior to the clamping of the ITA and all its branches

Orbital extension of trigeminal schwannoma

Schwannomas, also known as neurilemmomas, are benign peripheral nerve sheath tumors. Trigeminal schwannomas are rare intracranial tumors. Here, we report a 35-year-old female presenting with an axial proptosis of right eyeball with right-sided III, IV and VI cranial nerve palsy. Her best corrected visual acuity in the right eye was perception of light absent and in the left eye was 20/20. MRI scan revealed a large right-sided heterogeneous, extra-axial middle cranial fossa mass that extended to the intraconal space of right orbit. A diagnosis of intracranial trigeminal nerve schwannoma with right orbital extension was made. Successful surgical excision of the mass with preservation of the surrounding tissues and orbital exenteration was done. Post-operative period was uneventful