Summary
Objectives
The recurrent laryngeal nerve and its branches form a great variety of anastomoses.
These nerve communications can alter the innervation patterns of the laryngeal muscles
and can affect both the diagnosis and treatment of paralyzed vocal cords. The aim
of this study was to assess the prevalence and anatomical characteristics of the laryngeal
nerve connections, and to review their function and clinical significance.
Study Design
Meta-analysis and systematic review.
Methods
The major electronic databases were thoroughly searched to identify all studies reporting
data on the anastomoses of the laryngeal nerves. Data on the prevalence of each type
of anastomosis were extracted and pooled into a meta-analysis using MetaXL version 3.0 (EpiGear International Pty. Ltd., Wilston, Queensland, Australia).
Results
Twenty-two cadaveric studies (n = 1404 hemilarynges) were included in the meta-analysis.
The two most common communications were Galen's anastamosis and the arytenoid plexus.
The pooled prevalence estimate for Galen's anastamosis was 76.7% (95% confidence interval
[CI]: 59.0–90.0), of which the single trunk type was most common (92.3%). The arytenoid
plexus had a pooled prevalence estimate of 79.7% (95% CI: 41.1–100).
Conclusions
Owing to the high prevalences and variability of nerve connections in the larynx,
detailed anatomical knowledge of these anastomoses can be crucial for the accurate
interpretation of laryngoscopy results, reducing iatrogenic injury during surgical
procedures, and facilitating the development of novel strategies for treating laryngeal
paralyses.
Key Words
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Article info
Publication history
Published online: December 06, 2016
Accepted:
November 3,
2016
Identification
Copyright
© 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
