The recurrent laryngeal nerve is a branch of the Vagus nerve.
Anatomy
The recurrent laryngeal nerve branches off from the vagus nerve at the level of the superior thoracic aperture. On the left, the nerve loops around the aortic arch, while on the right it loops around the subclavian artery, then ascends alongside the trachea back to the larynx, where it gives off several branches supplying the esophagus and trachea. The unique course of the recurrent laryngeal nerve results from complex ontogenetic processes and is directly related to the descent of the heart during development.
Neurosurgical relevance
During surgery in the region of the recurrent laryngeal nerve, it can be monitored using intraoperative neurophysiological monitoring, which is primarily used during thyroid surgery[^1]. In neurosurgery, the recurrent laryngeal nerve plays an important role in anterior approaches to the cervical spine. According to a meta-analysis from 2016, the risk of recurrent laryngeal nerve palsy following an ACDF is approximately 14%[^2].