2024 Volume 70 Issue 2 Pages 95-100
In thyroid surgery, a careful surgical technique is required to preserve the recurrent laryngeal nerve. In rare cases with an abnormal origin of the subclavian artery, the recurrent laryngeal nerve may become a non-recurrent inferior laryngeal nerve (NRILN). A NRILN branches directly from the vagus nerve. We experienced a case involving a thyroid tumor with an NRILN and an abnormal origin of the right subclavian artery. A 68-year-old woman was admitted to our hospital with a mass located in the anterior neck. A benign thyroid tumor (e.g., follicular adenoma) and cyst were listed as differential diagnoses. Hemithyroidectomy was performed. Although we evaluated the thyroid tumor, cervical and mediastinal lymph nodes, and lung lesions, we could not confirm the course of the aorta and subclavian artery. During the operation, we found that the NRILN branched directly from the vagus nerve. Reconfirmation of CT revealed the abnormal origin of the right subclavian artery. When performing thyroid surgery, in addition to the evaluation of the tumor and lymph nodes, surgeons should routinely check for vascular malformations such as visceral inversion and abnormal origins of the subclavian artery.
