Relationship between the internal laryngeal nerve and the triticeal cartilage: a potentially unrecognized compression site during anterior cervical spine and carotid endarterectomy operations.

R. Shane Tubbs, Joshua F. Dixon, Marios Loukas, Mohammadali Mohajel Shoja, Aaron A. Cohen-Gadol

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

The triticeal cartilage has received scant attention in the literature. To date, its relationship to the nearby internal laryngeal nerve has not been studied. Therefore, to elucidate further this anatomic relationship and its potential surgical implications, this study was performed. Eighty-six adult cadaveric sides underwent dissection of the internal laryngeal nerve near its penetration of the thyrohyoid membrane. The relationship of this nerve to the triticeal cartilage was documented. Measurements and histological analysis were performed on all cartilage specimens. We identified triticeal cartilage in 51% of the specimens and found it to be hyaline in nature. The triticeal cartilage was located in the upper, middle, and lower thirds of the thyrohyoid membrane in 14%, 66%, and 20% of sides, respectively. Regardless of the position of the triticeal cartilage within the thyrohyoid membrane, the internal laryngeal nerve crossed directly over the triticeal cartilage on 59% of sides. When present, the internal laryngeal nerve will cross over the triticeal cartilage in the majority of individuals. This relationship should be borne in mind during surgical manipulation in this area and when placing retractors during anterior neck operations including cervical discectomy/fusion and carotid endarterectomy. Compression of the internal laryngeal nerve against the solid triticeal cartilage can cause laryngeal nerve palsy and increase the risk of resultant postoperative aspiration.

Original languageEnglish (US)
JournalNeurosurgery
Volume66
Issue number6 Suppl Operative
StatePublished - Jan 1 2010
Externally publishedYes

Fingerprint

Laryngeal Nerves
Carotid Endarterectomy
Cartilage
Spine
Membranes
Diskectomy
Hyalin
Paralysis
Dissection
Neck

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Relationship between the internal laryngeal nerve and the triticeal cartilage : a potentially unrecognized compression site during anterior cervical spine and carotid endarterectomy operations. / Tubbs, R. Shane; Dixon, Joshua F.; Loukas, Marios; Mohajel Shoja, Mohammadali; Cohen-Gadol, Aaron A.

In: Neurosurgery, Vol. 66, No. 6 Suppl Operative, 01.01.2010.

Research output: Contribution to journalArticle

Tubbs, R. Shane ; Dixon, Joshua F. ; Loukas, Marios ; Mohajel Shoja, Mohammadali ; Cohen-Gadol, Aaron A. / Relationship between the internal laryngeal nerve and the triticeal cartilage : a potentially unrecognized compression site during anterior cervical spine and carotid endarterectomy operations. In: Neurosurgery. 2010 ; Vol. 66, No. 6 Suppl Operative.
@article{035e62697f504b27abb1f20294bec3ac,
title = "Relationship between the internal laryngeal nerve and the triticeal cartilage: a potentially unrecognized compression site during anterior cervical spine and carotid endarterectomy operations.",
abstract = "The triticeal cartilage has received scant attention in the literature. To date, its relationship to the nearby internal laryngeal nerve has not been studied. Therefore, to elucidate further this anatomic relationship and its potential surgical implications, this study was performed. Eighty-six adult cadaveric sides underwent dissection of the internal laryngeal nerve near its penetration of the thyrohyoid membrane. The relationship of this nerve to the triticeal cartilage was documented. Measurements and histological analysis were performed on all cartilage specimens. We identified triticeal cartilage in 51{\%} of the specimens and found it to be hyaline in nature. The triticeal cartilage was located in the upper, middle, and lower thirds of the thyrohyoid membrane in 14{\%}, 66{\%}, and 20{\%} of sides, respectively. Regardless of the position of the triticeal cartilage within the thyrohyoid membrane, the internal laryngeal nerve crossed directly over the triticeal cartilage on 59{\%} of sides. When present, the internal laryngeal nerve will cross over the triticeal cartilage in the majority of individuals. This relationship should be borne in mind during surgical manipulation in this area and when placing retractors during anterior neck operations including cervical discectomy/fusion and carotid endarterectomy. Compression of the internal laryngeal nerve against the solid triticeal cartilage can cause laryngeal nerve palsy and increase the risk of resultant postoperative aspiration.",
author = "Tubbs, {R. Shane} and Dixon, {Joshua F.} and Marios Loukas and {Mohajel Shoja}, Mohammadali and Cohen-Gadol, {Aaron A.}",
year = "2010",
month = "1",
day = "1",
language = "English (US)",
volume = "66",
journal = "Neurosurgery",
issn = "0148-396X",
publisher = "Lippincott Williams and Wilkins",
number = "6 Suppl Operative",

}

TY - JOUR

T1 - Relationship between the internal laryngeal nerve and the triticeal cartilage

T2 - a potentially unrecognized compression site during anterior cervical spine and carotid endarterectomy operations.

AU - Tubbs, R. Shane

AU - Dixon, Joshua F.

AU - Loukas, Marios

AU - Mohajel Shoja, Mohammadali

AU - Cohen-Gadol, Aaron A.

PY - 2010/1/1

Y1 - 2010/1/1

N2 - The triticeal cartilage has received scant attention in the literature. To date, its relationship to the nearby internal laryngeal nerve has not been studied. Therefore, to elucidate further this anatomic relationship and its potential surgical implications, this study was performed. Eighty-six adult cadaveric sides underwent dissection of the internal laryngeal nerve near its penetration of the thyrohyoid membrane. The relationship of this nerve to the triticeal cartilage was documented. Measurements and histological analysis were performed on all cartilage specimens. We identified triticeal cartilage in 51% of the specimens and found it to be hyaline in nature. The triticeal cartilage was located in the upper, middle, and lower thirds of the thyrohyoid membrane in 14%, 66%, and 20% of sides, respectively. Regardless of the position of the triticeal cartilage within the thyrohyoid membrane, the internal laryngeal nerve crossed directly over the triticeal cartilage on 59% of sides. When present, the internal laryngeal nerve will cross over the triticeal cartilage in the majority of individuals. This relationship should be borne in mind during surgical manipulation in this area and when placing retractors during anterior neck operations including cervical discectomy/fusion and carotid endarterectomy. Compression of the internal laryngeal nerve against the solid triticeal cartilage can cause laryngeal nerve palsy and increase the risk of resultant postoperative aspiration.

AB - The triticeal cartilage has received scant attention in the literature. To date, its relationship to the nearby internal laryngeal nerve has not been studied. Therefore, to elucidate further this anatomic relationship and its potential surgical implications, this study was performed. Eighty-six adult cadaveric sides underwent dissection of the internal laryngeal nerve near its penetration of the thyrohyoid membrane. The relationship of this nerve to the triticeal cartilage was documented. Measurements and histological analysis were performed on all cartilage specimens. We identified triticeal cartilage in 51% of the specimens and found it to be hyaline in nature. The triticeal cartilage was located in the upper, middle, and lower thirds of the thyrohyoid membrane in 14%, 66%, and 20% of sides, respectively. Regardless of the position of the triticeal cartilage within the thyrohyoid membrane, the internal laryngeal nerve crossed directly over the triticeal cartilage on 59% of sides. When present, the internal laryngeal nerve will cross over the triticeal cartilage in the majority of individuals. This relationship should be borne in mind during surgical manipulation in this area and when placing retractors during anterior neck operations including cervical discectomy/fusion and carotid endarterectomy. Compression of the internal laryngeal nerve against the solid triticeal cartilage can cause laryngeal nerve palsy and increase the risk of resultant postoperative aspiration.

UR - http://www.scopus.com/inward/record.url?scp=79952110446&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79952110446&partnerID=8YFLogxK

M3 - Article

C2 - 20489504

AN - SCOPUS:79952110446

VL - 66

JO - Neurosurgery

JF - Neurosurgery

SN - 0148-396X

IS - 6 Suppl Operative

ER -