Vol. 7, Issue 1, Part A (2025)

Background: Thyroidectomy is one of the most commonly performed head and neck surgical procedures. Understanding the surgical anatomy of the relationship between recurrent laryngeal nerve (RLN) and the inferior thyroid artery (ITA) and its possible variations is paramount to safe and effective thyroid surgery. 
Objectives: To find out the position of RLN in relation to ITA. 
Methods: This Cross-sectional observational study done in Department of ENT and Head Neck Surgery, Dhaka Medical College and Hospital, Dhaka, Bangladesh from May 2022 to April 2023. Patients having benign or malignant thyroid disease fulfilling the inclusion and exclusion criteria undergone thyroidectomy operation was included. Data on various types of relationships between RLN and ITA were recorded. The collected data was manage statistically using SPSS version 22. 
Results: The study included 180 patients (125 Females and 55 males). Total of 261 nerves were identified (all are recurrent), 136 nerve on right side and 125 nerve on left side. Three variations of RLN were clarified on both sides. On the right side the nerve was found in 83(61.0%) instances dorsal to the artery, 38(28.0%) ventral to the artery and 15(11.0%) in between the branches. On the left side the nerve was found in 87(69.6%) dorsal to the artery, 19(15.2%) ventral to the artery and in 19(15.2%) in between the branches. 
Conclusions: The anatomical relationship between RLN and ITA is highly variable. For all head and neck surgeons to perform safe surgery on thyroid, it is necessary to have sound anatomical knowledge of these variable relationships between RLN and ITA.