Intraoperative identification of a left non-recurrent laryngeal nerve by neuromonitoring: a critical anatomical finding—case report
Journal
Journal of Surgical Case Reports
ISSN
2042-8812
Publisher
Oxford University Press
Date Issued
2026
Author(s)
Lanzagorta Ortega, Dioselina
Hernández Martínez, Ana Sofía
Gómez Woodworth, Juan Ramón
Peña Garcia, Juan Francisco
Mercado Atri, Moises
Jean Silver, Enrique Ricardo
Type
text::journal::journal article
Abstract
Injury to the recurrent laryngeal nerve (RLN) and its non-recurrent variant (NRLN) remains one of the most significant complications of thyroid and parathyroid surgery. The NRLN is a rare anatomical variation that arises directly from the cervical vagus nerve without looping into the thoracic cavity, most often associated with an aberrant subclavian artery. Identification of this structure is essential to avoid iatrogenic injury, particularly during thyroidectomy. We report the intraoperative neuromonitoring (IONM) identification of an unexpected non-recurrent left inferior laryngeal nerve; emerging directly from the vagus nerve and coursing horizontally towards the larynx. This case emphasizes the importance of IONM, surgical awareness of anatomical variation to prevent RLN and NRLN injury, and ensuring optimal postoperative laryngeal function. © The authors © Oxford University Press
License
Acceso Abierto
How to cite
Lanzagorta Ortega, D., Hernández Martínez, A. S., Gomez Woodworth, J. R., Peña Garcia, J. F., Mercado Atri, M., & Jean Silver, E. R. (2026). Intraoperative identification of a left non-recurrent laryngeal nerve by neuromonitoring: a critical anatomical finding—case report. Journal of Surgical Case Reports, 2026(6). https://doi.org/10.1093/jscr/rjag427