SynthesisLangenbeck's archives of surgery2016
Extralaryngeal branching of the recurrent laryngeal nerve: a meta-analysis of 28,387 nerves.
Synthesis in Langenbeck's archives of surgery, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The current state of intermittent intraoperative neural monitoring for prevention of recurrent laryngeal nerve injury during thyroidectomy: a PRISMA-compliant systematic review of overlapping meta-analyses.Langenbeck's archives of surgery · 2017Pooled it
- The Reliability of the Tracheoesophageal Groove and the Ligament of Berry as Landmarks for Identifying the Recurrent Laryngeal Nerve: A Cadaveric Study and Meta-Analysis.BioMed research international · 2017Pooled it
- Clinical manifestations of injured tracheal and esophageal branches of the recurrent laryngeal nerve following thyroid surgery.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2026Article
- High risk of true extralaryngeal branch of recurrent laryngeal nerves during thyroid surgery.Singapore medical journal · 2026Article
- Anatomical variations of the recurrent laryngeal nerve and postoperative outcomes in thyroid surgeries conducted at a teaching hospital in Ethiopia.Scientific reports · 2025Observational
- Preventing Laryngeal Nerve Palsy During Thyroidectomies: A Non-systematic Review of the Surgical Anatomy Literature.Cureus · 2025Review
- Nerve Branch Diameter as an Indicator of Motor Function in Extralaryngeal Branches of the Recurrent Laryngeal Nerve During Thyroidectomy.Laryngoscope investigative otolaryngology · 2025Article
- The relation of recurrent laryngeal nerve to inferior thyroid artery and extralaryngeal nerve branching may increase the risk of vocal cord paralysis in thyroidectomy.Langenbeck's archives of surgery · 2024Article
- Risk of Dysphagia and Dysphonia in Patients With Prior Thyroidectomy Undergoing Anterior Cervical Discectomy and Fusion.Global spine journal · 2024Article
- Facial nerve monitoring in parotid gland surgery: Design and feasibility assessment of a potential standardized technique.World journal of otorhinolaryngology - head and neck surgery · 2023Article
- Systematic Review and Meta-Analysis: Recurrent Laryngeal Nerve Variants and Their Implication in Surgery and Neck Pathologies, Using the Anatomical Quality Assurance (AQUA) Checklist.Life (Basel, Switzerland) · 2023Review
- Clinical and Anatomical Factors Affecting Recurrent Laryngeal Nerve Paralysis During ThyroidectomyFrontiers in surgery · 2022Article
- Anatomical, Functional, and Dynamic Evidences Obtained by Intraoperative Neuromonitoring Improving the Standards of Thyroidectomy.Sisli Etfal Hastanesi tip bulteni · 2021Review
- The Most Common Anatomical Variation of Recurrent Laryngeal Nerve: Extralaryngeal Branching.Sisli Etfal Hastanesi tip bulteni · 2021Article
- Anatomical Variations of the Recurrent Laryngeal Nerve and Implications for Injury Prevention during Surgical Procedures of the Neck.Diagnostics (Basel, Switzerland) · 2020Article
- Role of intraoperative neuromonitoring of recurrent laryngeal nerve in thyroid and parathyroid surgery.The Journal of international medical research · 2020Article
- Article
- Prophylactic Central Neck Dissection in Well-differentiated Thyroid Cancer.Acta clinica Croatica · 2020Review
- Extra-laryngeal branching of recurrent laryngeal nerve: a possibility thyroid surgeons need to keep in mind to prevent inadvertent nerve injury.BMJ case reports · 2019Article
- Adaptive self-organization in the embryo: its importance to adult anatomy and to tissue engineering.Journal of anatomy · 2018Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe recurrent laryngeal nerves (RLN) are branches of the vagus nerve that go on to innervate most of the intrinsic muscles of the larynx. Historically, the RLN has been considered to branch after it enters the larynx, but numerous studies have demonstrated that it often branches before. The wide variability of this extralaryngeal branching (ELB) has significant implications for the risk of iatrogenic injury. We aimed to assess the anatomical characteristics of ELB comprehensively.
methodsArticles on the ELB of the RLN were identified by a comprehensive database search. Relevant data were extracted and pooled into a meta-analysis of the prevalence of branching, branching pattern, distance of ELB point from the larynx, and presence of positive motor signals in anterior and posterior ELB branches.
resultsA total of 69 articles (n = 28,387 nerves) from both intraoperative and cadaveric modalities were included in the meta-analysis. The overall pooled prevalence of ELB was 60.0 % (95 % CI 52.0-67.7). Cadaveric and intraoperative subgroups differed with prevalence rates of 73.3 % (95 % CI 61.0-84.0) and 39.2 % (95 % CI 29.0-49.9), respectively. Cadavers most often presented with a ELB pattern of bifurcation, with a prevalence of 61.1 %, followed by no branching at 23.4 %. Branching of the RLN occurred most often at a distance of 1-2 cm (74.8 % of cases) prior to entering the larynx. A positive motor signal was most often noted in anterior RLN branches (99.9 %) but only in 1.5 % of posterior branches.
conclusionsThe anatomy of the RLN is highly variable, and ELB is likely to have been underreported in intraoperative studies. Because of its high likelihood, the possibility of ELB needs to be assessed in patients to prevent iatrogenic injury and long-term postoperative complications.
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