During total thyroidectomy, the recurrent laryngeal nerve (RLN) is most vulnerable to injury at which specific anatomical location?

• A At the superior thyroid pole during ligation of the superior thyroid artery
• B At the thoracic inlet where the nerve enters the mediastinum
• C Where the nerve enters the larynx posterior to the cricothyroid joint
• D Where the nerve crosses the inferior thyroid artery, near the ligament of Berry ✓

Explanation

The RLN is most vulnerable where it crosses the inferior thyroid artery and enters the larynx at the ligament of Berry, where it is densely adherent to the posterior thyroid capsule. Option A describes the site of external laryngeal nerve injury. The thoracic inlet is distant from the surgical field. The nerve entry into the larynx is a fixed landmark but less commonly injured than the Berry ligament region.

Reference: Bailey and Love's Short Practice of Surgery, 28th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.