Nerve
Recurrent laryngeal nerve
Vagal motor and sensory supply returning to the larynx
High-yield
The longer left intrathoracic course exposes this nerve to disease in the aortopulmonary region. A rare nonrecurrent right nerve is strongly associated with an aberrant right subclavian artery.
Overview
Each recurrent nerve turns beneath an artery before ascending toward the larynx. The right loops around the subclavian artery; the left passes beneath the aortic arch. Their cervical courses approach the tracheoesophageal groove, with considerable variation, particularly on the right.
Reference facts
- Origin
- CN X: the right branch usually arises near the subclavian artery and the left near the aortic arch.
- Root value
- Vagal branchiomotor and visceral sensory fibers; this is a cranial nerve branch, not a spinal-root nerve.
- Course
- Returns upward near the trachea and esophagus, crosses the inferior thyroid artery variably, and enters behind the cricothyroid joint.
- Motor
- Principal supply to intrinsic laryngeal muscles other than cricothyroid; also contributes to upper esophageal and pharyngeal muscle innervation.
- Sensory
- Infraglottic mucosa and nearby upper tracheal and esophageal territories.
Clinical correlation
One-sided injury may produce a weak, breathy voice and ineffective closure. Bilateral injury can threaten the airway, but vocal-fold position varies. Thoracic tumors or cardiovascular enlargement can affect the left nerve; cardiovocal syndrome does not imply one universal site of compression.
Frequently asked questions
What type of nerve is the recurrent laryngeal nerve?
Vagal branchiomotor and visceral sensory fibers; this is a cranial nerve branch, not a spinal-root nerve.
What muscles does the recurrent laryngeal nerve supply?
Principal supply to intrinsic laryngeal muscles other than cricothyroid; also contributes to upper esophageal and pharyngeal muscle innervation.
What is the sensory distribution of the recurrent laryngeal nerve?
The recurrent laryngeal nerve carries sensation from the infraglottic mucosa and nearby upper tracheal and esophageal territories.
What is the course of the recurrent laryngeal nerve?
Returns upward near the trachea and esophagus, crosses the inferior thyroid artery variably, and enters behind the cricothyroid joint.