The ligament of Berry (posterior suspensory ligament of the thyroid) connects the posteromedial thyroid gland to the cricoid cartilage and upper tracheal rings, suspending the thyroid from the laryngotracheal framework.
Anchors the thyroid gland to the trachea and cricoid, maintaining thyroid position during swallowing, transmitting the upward movement of the thyroid with laryngeal elevation, and providing the posterior tethering that the surgeon must divide during thyroid mobilisation.
The recurrent laryngeal nerve passes in close proximity to or through the ligament of Berry — this is the most dangerous zone for RLN injury during thyroidectomy. The nerve may branch within the ligament, making identification critical. The ligament of Berry is divided last during thyroid lobe removal.
Recurrent laryngeal nerve injury from traction, heat, or division at the ligament of Berry during thyroidectomy — the highest-risk zone for RLN damage, requiring meticulous sharp dissection and nerve monitoring.
The ligament of Berry causes the thyroid gland to move upward with swallowing — this movement is used clinically to confirm thyroid gland origin of a neck mass.
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