BMJ Case Reports 2017; doi:10.1136/bcr-2016-218280

Non-recurrent laryngeal nerve with a coexisting contralateral nerve demonstrating extralaryngeal branching

  1. Julian A McGlashan
  1. Department of Ear, Nose & Throat, Queen's Medical Centre, Nottingham, UK
  1. Correspondence to James D Constable, james.constable{at}
  • Accepted 3 March 2017
  • Published 17 March 2017


Non-recurrence and extralaryngeal branching are 2 of the more frequently encountered anomalies of the recurrent laryngeal nerve. If not anticipated intraoperatively, these abnormalities can put the nerve at risk, with subsequent vocal cord palsy. It is therefore important to report on and understand these abnormalities. We present a unique case of a non-recurrent laryngeal nerve with a coexisting contralateral nerve demonstrating extralaryngeal branching. This case allows us to demonstrate the importance of arteria lusoria in head and neck surgery, and to conclude that non-recurrence and extralaryngeal branching can occur separately within individual nerves in the same patient. The case also highlights the importance of a systematic intraoperative approach to the identification of every recurrent laryngeal nerve, especially in bilateral procedures having already exposed an anomalous nerve on one side.


  • Contributors JDC is the lead author. SB and JAM were involved in identification of case, contributions to discussion and key learning points. JDC and JJA were involved in literature review for discussion, and preparation of case presentation including figures.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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