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Preoperative CT diagnosis of aberrant right subclavian artery and prediction of a nonrecurrent laryngeal nerve: a case report

Year: 2026

Type: article

Abstract: Introduction: The nonrecurrent laryngeal nerve (NRLN) is a rare anomaly associated with an aberrant right subclavian artery (ARSA). Preoperative recognition is critical to prevent injury during thyroid surgery. Case presentation: A 24-year-old male presented with a right neck mass. Preoperative contrast-enhanced CT revealed ARSA originating from the aortic arch and passing behind the esophagus, suggesting a right NRLN. During endoscopic bilateral total thyroidectomy via a breast approach (ETBA), a Type I NRLN (Toniato) was identified originating directly from the cervical vagus and entering the larynx laterally; it was preserved intact. The patient recovered uneventfully, with normal vocal function at discharge and throughout 14 months of follow-up. Discussion: CT detection of an ARSA should alert surgeons to the possibility of an NRLN, guiding intraoperative dissection away from the tracheoesophageal groove toward the vagal trunk. Conclusion: Preoperative CT is a valuable tool for predicting NRLN. Surgeons should remain vigilant when ARSA is present to enable early nerve identification and preservation.

Source: International Journal of Surgery Case Reports

DOI: 10.1097/rc9.0000000000000894

Authors: Shuxiong Li, Zhanhui Chen, Yunqing Li, Dongwei Li

Institution: Guangdong Medical College

Language: English

Topic: Thyroid and Parathyroid Surgery

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,090