Anatomical relationship between recurrent laryngeal nerve and inferior thyroid artery in thyroidectomy patients.

BACKGROUND Thyroid surgery is performed very frequently now a day. Previously it was used to be associated with high morbidity especially hoarseness. This complication is now almost negligible as most of the surgeons are well acquainted with the anatomical knowledge of the nerves in relation to the gland. The objective of this study was to find out variable anatomical relationships between Recurrent Laryngeal Nerve and Inferior Thyroid Artery in patients undergoing thyroid surgery. METHODS This cross-sectional retrospective study was conducted in Government Lady Reading Hospital Peshawar and Abasyn Hospital (Private) Peshawar from May 2010 to June 2014. Patients undergoing surgery for benign goiters, T1, T2 well differentiated thyroid cancers without lymph node involvement was included. Data on various types of relationships between RLN and ITA were recorded. RESULTS In total 271 patients operated and included in the study, 117 were male and 154 were female. Total of 398 RLNs were identified in 416 sides operated. In 55.27% cases the nerve was found to be anterior to inferior thyroid artery while it was posterior to the artery in 34.67% cases. In the remaining 10.05% cases the nerve was observed passing within the branches of inferior thyroid artery. CONCLUSIONS The anatomical relationship between Recurrent Laryngeal Nerve RLN and Inferior Thyroid Artery ITA is highly variable. For all head and neck surgeons to perform safe surgery on thyroid, it is necessary to have sound anatomical knowledge of these variable relationships between recurrent laryngeal nerve and inferior thyroid artery.