Anastamoses and bifurcations of the recurrent laryngeal nerve--report of 1177 nerves visualized.

One thousand seventy-seven recurrent laryngeal nerves were observed in 719 patients. Seven hundred forty-seven nerves bifurcated or trifurcated over 0.5 cm inferior to the cricoid cartilage (63%). Of these, 170 patients had bilateral nerve bifurcations. Thirty-nine per cent of the patients had bilateral bifurcations when one side bifurcated. Eleven patients had direct laryngeal nerves, two of which bifurcated. Five of these 11 patients also had a recurrent and direct laryngeal nerve. Seven patients had recurrent laryngeal nerves, all on the right side, receiving branches directly from the vagus nerve 6-14 cm from the cricoid. Damage to any filaments to or from the recurrent laryngeal nerve can cause vocal cord paralysis. Damage to branches to the esophagus from the recurrent laryngeal nerve can cause dysphagia.