Nothing unusual: bilateral recurrent laryngeal nerves have followed the rule

Excerpt

Yan et al. [4] have explained the course of bilateral recurrent laryngeal nerves (RLN) in a cadaver. The description of the aortic arch anatomy suggests that it is a right aortic arch (RAA) with an aberrant left subclavian artery with a Kommerall diverticulum and a left sided ductus/ligamentum, with the possibility of a circumflex aorta which is difficult to ascertain as it is a cadaveric study. The anatomy was explained in 1963 by Felson et al. [2] and again in 1970 by Shuford et al. [3] with embryological basis. Embryologically the RAA arises from the 4th right primitive branchial arch vessel and the RLN always courses around the distal primitive 6th arch vessel. The final course of the RLN is decided by the disappearance of the branchial arch vessels during development. …