The relationship between the vagus nerve and the common carotid artery in thyroid surgery: an ultrasonographic study.

IF 1.2 4区医学 Q2 Medicine

Surgical and Radiologic Anatomy Pub Date : 2026-10-12 DOI:10.1007/s00276-026-04025-3

Simge Eşme, Duygu Kalaycı, Berin Tuğtağ Demir, Burak Bilecenoğlu, Kaan Orhan

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引用次数: 0

Abstract

Purpose: To evaluate the positional relationship of the cervical vagus nerve with the common carotid artery (CCA) and internal jugular vein (IJV) using high-resolution ultrasonography and to identify anatomical variations relevant to vagus nerve localization during intraoperative neuromonitoring (IONM) in thyroid surgery.

Methods: This prospective observational study included 97 individuals aged 20-30 years, providing 194 cervical sides for analysis. The vagus nerve was evaluated bilaterally using high-resolution ultrasonography and classified into six positional patterns according to its relationship with the CCA and IJV. Positional distributions were compared according to side and sex.

Results: Position 1 was the most frequent configuration (n = 128, 66.0%), followed by Position 2 (n = 59, 30.4%). Positions 3 and 4 were observed in 5 (2.6%) and 2 (1.0%) sides, respectively. Positions 5 and 6 were not observed in any case. Thus, the vagus nerve was predominantly located between the great vessels, while superficial and medial-superficial variants were uncommon. No statistically significant association was found between vagus nerve position and side or sex (all p > 0.05).

Conclusion: The cervical vagus nerve exhibits positional variation within the carotid sheath, although it is predominantly located between the CCA and IJV. High-resolution ultrasonography allows identification of these anatomical variations and may facilitate preoperative localization of the vagus nerve, potentially supporting safer IONM and reducing the risk of iatrogenic neural injury during thyroid surgery.

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来源期刊

Surgical and Radiologic Anatomy Medicine-Pathology and Forensic Medicine

CiteScore

2.40

自引率

14.30%

发文量

期刊介绍： Anatomy is a morphological science which cannot fail to interest the clinician. The practical application of anatomical research to clinical problems necessitates special adaptation and selectivity in choosing from numerous international works. Although there is a tendency to believe that meaningful advances in anatomy are unlikely, constant revision is necessary. Surgical and Radiologic Anatomy, the first international journal of Clinical anatomy has been created in this spirit. Its goal is to serve clinicians, regardless of speciality-physicians, surgeons, radiologists or other specialists-as an indispensable aid with which they can improve their knowledge of anatomy. Each issue includes: Original papers, review articles, articles on the anatomical bases of medical, surgical and radiological techniques, articles of normal radiologic anatomy, brief reviews of anatomical publications of clinical interest. Particular attention is given to high quality illustrations, which are indispensable for a better understanding of anatomical problems. Surgical and Radiologic Anatomy is a journal written by anatomists for clinicians with a special interest in anatomy.