Case reports:
Case 1:
A 60 years-old woman presented with a multinodular goiter.
Ultrasonography (US) showed intra-thoracic extension of goiter. A CT
scan have been done and confirmed plunging goiter. CT scan discovered
also an ARSA compressing the esophagus (fig.1) . Knowing this,
the surgeon was aware of the presence of a NRLN. The patient underwent a
total thyroidectomy. A NRLN has been found. It had a linear course at
the level of the upper thyroid pole (fig.2) . Identification and
dissection were simple; no vocal palsy was noted post operatively.
Case 2:
A 56 years-old woman has been referred for primary hyperparathyroidism.
Ultrasonography showed an inferior right parathyroid adenoma measuring
7*18mm. Parathyroid scintigraphy confirmed right inferior parathyroid
adenoma. The patient underwent a parathyroidectomy. The right laryngeal
nerve has been found non recurrent during surgery, after unsuccessful
investigation in classic landmarks. It had a linear course transversally
at the level of the thyroid isthmus. Surgical outcome was good with no
vocal palsy. Since the patient suffered from dysphagia, ARSA was a
possible explanation to it. After the patient’s consent, CT scan was
performed and confirmed an ARSA (fig. 3).