Anatomical variations of the recurrent laryngeal nerve and postoperative outcomes in thyroid surgeries conducted at a teaching hospital in Ethiopia
Bibliographic record
Abstract
Thyroid surgery requires a thorough knowledge of the neck anatomy and its anatomical variations. This is of utmost importance since it is well known that variations of the recurrent laryngeal nerve are prone to iatrogenic injuries. Injury to the recurrent laryngeal nerve is one of the most severe complications of thyroid surgery. Surgeons must comprehensively understand the anatomy of the recurrent laryngeal nerve during thyroid operation. To assess the anatomical variations of recurrent laryngeal nerves, with inferior approach using inferior thyroid artery as a consistent anatomical landmark, and outcomes in patients who had undergone thyroid surgery in Tibebe Ghion Specialised Hospital, Bahir Dar, Ethiopia. An institutional-based prospective observational study of 102 consecutive patients was conducted from June 2021 to August 2022 at Tibebe Ghion Specialized Hospital, Bahir Dar, Ethiopia. Data were collected prospectively using a standardized intraoperative checklist and intraoperative photographs. The study included 102 patients (92 female, 10 male). Age distribution was 18-39 years: 53.9%; 40-60 years: 42.2%; 61-80 years: 3.9%. A total of 156 RLNs were dissected: 87 right and 69 left. Right-side branching was observed in 24.1% of nerves (single trunk 75.9%; bifurcation 18.4%; trifurcation 5.7%); left-side branching occurred in 10.2% (single trunk 89.8%; bifurcation 10.2%). In relation to the ITA, right RLNs were posterior in 68.9%, anterior in 27.7%, and interdigitating among arterial branches in 3.4%; left RLNs were posterior in 91.3%, anterior in 7.3%, and interdigitating in 1.4%. Using the operative landmark of the tracheoesophageal groove (TEG - defined here as the space between the trachea and esophagus at the level of dissection), 93.1% of right RLNs were identified within or adjacent to the TEG and 6.9% were lateral to the tracheal surface; 100% left RLNs were identified within or adjacent to the TEG. Early postoperative course was uneventful in 92.2%; transient hoarseness occurred in 2.0%. Anatomical consideration of the variations in the course, branching pattern, and relation of recurrent laryngeal nerve with inferior thyroid artery and tracheoesophageal groove is essential to minimize complications associated with surgical procedures of the neck, especially thyroidectomy.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".