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Right versus Left Sided Exposures of the Recurrent Laryngeal Nerve (RLN) and its' Branches- A Fresh Cadaveric Study Relevant to the Cervical Spine

Traction neuropraxia of the upper oesophageal branches of the RLN nerve may provide an alternative explanation for the transient post-op dysphagia (upto 60%). The laryngeal supply of the RLN benefits from Galen’s anastomotic nerve supply of SLN (Ansa of Galen) and hence the neuropraxia of the nerve is less frequently symptomatic. Below C5, the left sided anterior cervical approach permits a wider access to the entire anterior cervical spine with less risk to the RLN. Neuropraxia induced on the oesophageal branches (directly by retractors or indirectly by traction) could provide a possible explanation for transient post-op dysphagia. We believe that this will help spinal surgeons to refine their surgical technique and thus reduce the incidence of iatrogenic injury.