Recurrent laryngeal nerve – DNB Ent Theory/ VIVA/ station
Recurrent laryngeal nerve
The recurrent laryngeal nerve is a myelinated nerve. It is a component of the vagus nerve. As the vagus nerve exits the medulla, the fibers of the recurrent laryngeal nerve are anteriorly situated in it. As the vagus traverses inferiorly, the fibers of the recurrent laryngeal nerve starts to rotate medially until they are ultimately separated from the vagus nerve. The vagus nerve has a superior ganglion at the level of the jugular foramen.. This ganglion is also known as jugular ganglion. This ganglion contains cell bodies of parasympathetic and sensory fibres that run in the vagus.
Inside the jugular foramen the vagus nerve consists of multiple bundles of nerve fibers. Tumors in the jugular foramen can infiltrate these fasicles without loss of vagal integrity. The vagus nerve leaves the skull base via the jugular foramen anterior to the jugular vein. The vagus then assumes a more posterior position medial to the jugular vein. The vagus nerve has an inferior ganglion also known as the nodose ganglion immediatly below the jugular foramen. The vagal supply to the pharyngeal plexus and the superior laryngeal nerve arise from this ganglion.
The course taken by the vagus nerve differs between the right and the left sides. The left vagus nerve follows the carotid artery into the mediastinum crossing anterior to the aortic arch. The recurrent laryngeal nerve arising from the vagal nerve just below the aortic arch loops medially under the aorta and ascends within the tracheoesophageal groove.
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