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Non-recurrent laryngeal nerve: surgical risk of injury in comparison with the normal recurrent laryngeal nerve - A systematic review and meta-analysis
  • Jensen Tsun-Ki So,
  • Chris Thompson
Jensen Tsun-Ki So
Yan Chai Hospital

Corresponding Author:sotsunki@gmail.com

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Chris Thompson
The University of Edinburgh Edinburgh Medical School
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Abstract

Introduction: The non-recurrent laryngeal nerve (NRLN) is a known anatomical variation of the normal recurrent laryngeal nerve (RLN). Its prevalence is estimated <1% and is prone to higher risk of iatrogenic injury. The risk of injury during thyroid surgery have been reported as variable in current literature, from 0% up to 12%. This study aimed to systematically review the incidence of NRLN injury and present the results through meta-analysis. The incidence of injury to NRLN and RLN was compared and analysed to determine its statistical significance. Methods: The PRISMA protocol was followed for an online search of prominent literatures. Studies were selected and excluded according to specific criteria. Quality assessment was performed, and data was extracted. Meta-analysis was conducted for the incidence of injury of the NRLN, and its comparison to the RLN. Results were presented in the form of a systematic review and discussed. Results: 17 studies were included in the final analysis. It was found that the pooled risk of NRLN injury was 7% and the risk ratio of injury in comparison to the RLN was 3.8, showing a statistically significant difference. Conclusion: This is the first study to report the overall risk of injury to the NRLN and found a statistically significant difference in comparison to the injury of RLN. This evidence provides grounds for future surgical guidelines to prevent injury to the NRLN. It is suggested that intra-operative nerve monitoring (IONM) should be performed in all patients found to have NRLN pre-operatively and intra-operatively.
Submitted to Clinical Otolaryngology
Assigned to Editor
Submission Checks Completed
Reviewer(s) Assigned
09 Aug 2024Reviewer(s) Assigned
17 Aug 2024Review(s) Completed, Editorial Evaluation Pending
09 Sep 2024Editorial Decision: Revise Major
17 Oct 20241st Revision Received
18 Oct 2024Assigned to Editor
18 Oct 2024Submission Checks Completed
04 Nov 2024Reviewer(s) Assigned
14 Nov 2024Review(s) Completed, Editorial Evaluation Pending
30 Nov 2024Editorial Decision: Revise Minor
10 Dec 20242nd Revision Received
13 Dec 2024Submission Checks Completed
13 Dec 2024Assigned to Editor
23 Dec 2024Reviewer(s) Assigned
27 Dec 2024Review(s) Completed, Editorial Evaluation Pending