Intraoperative finding non-recurrent inferior laryngeal nerve, critical step of thyroid surgery, literature review, and case report

Introduction: Non-recurrent laryngeal nerve is a relatively rare finding occurring in 0.3%-0.5% of people. Other authors estimate that prevalence was 0.7%. Observation: We present a case of a female 48 years old who underwent hemithyroidectomy due to a thyroid nodule, identifying the presence of a non-recurring vertical variant laryngeal nerve. Discussion: The importance lies in the knowledge of the anatomical variations of the inferior laryngeal nerve (ILN). Since unilateral laryngeal paralysis is a complication associated with thyroidectomy, which is globally between 5 and 8% (transient) and 1 and 3% (permanent). The ILN should always be identified and meticulous surgical technique is necessary. Conclusions: ILN dissection should be guided by neurostimulation, if not counted, the recommendation that always should be followed is not to dissect structures until the laryngeal nerve is correctly identified.