The inferior thyroid artery provides the primary blood supply to the parathyroid glands and the lower pole of the thyroid, and its relationship to the recurrent laryngeal nerve is the critical surgical anatomy of thyroid surgery. The RLN crosses the inferior thyroid artery at the level of the thyroid's posterior surface in variable relationships — anterior to the artery in 30 percent, posterior in 30 percent, and between its branches in 40 percent.
| Origin | Thyrocervical trunk from the subclavian artery |
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The inferior thyroid artery crossing relationship with the recurrent laryngeal nerve is the most important landmark in thyroid surgery — the RLN is traced to the cricothyroid junction by following it from its identification at the inferior thyroid artery crossing point. Inadvertent RLN traction during inferior thyroid artery ligation is the most common cause of post-thyroidectomy hoarseness.
Recurrent laryngeal nerve traction or division during inferior thyroid artery ligation producing vocal cord palsy and hoarseness, the most common serious thyroid surgery complication.
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