Abstract
In thyroid and parathyroid surgery, the treatment of recurrent nerve is important, and in order to prevent nerve damage during surgery, it is necessary to be careful of its running route.
There are several subtypes of running route of recurrent nerve, and the non-recurrent inferior laryngeal nerve （NRILN） is a subtype that must not be overlooked. The patient was a 52-year-old male suffering from hoarseness. Left recurrent nerve palsy was seen, and surgery was performed due to a diagnosis of bilateral cervical lymph node metastasis of thyroid papillary carcinoma. During surgery, the right lower laryngeal nerve branched directly from the vagus nerve and it was confirmed that it flowed into the larynx. Post-surgically, we checked the pre-operative cervico-computed tomography scan again and noticed an abnormality of the right subclavian artery, and NRILN was suggested. When an abnormality in the blood vessel branching morphology is seen, surgical operation should be carried out carefully, considering the possible existence of NRILN.
