The ligament of berry

Niranjan Sritharan, Paul M. Paddle, Samuel K. Snyder, Jonathan W. Serpell

Research output: Chapter in Book/Report/Conference proceedingChapter (Book)Otherpeer-review

Abstract

The last 2 cm of the extralaryngeal course of the recurrent laryngeal nerve is an area of critical anatomical importance. It is the site of greatest risk for neuropraxia, the site of development of the artificial genu and point of maximal tension within the recurrent laryngeal nerve at thyroidectomy and the site of bifurcation of the recurrent laryngeal nerve. In this last 2 cm segment, the Ligament of Berry which attaches the thyroid to the trachea is located. Two fascial layers are described in the region of the Ligament of Berry, covering the last 2 cm of the extralaryngeal course of the recurrent nerve. The more superficial layer, the superficial vascular fascial layer, contains branches of the inferior thyroid artery, the superior parathyroid gland, and the Tubercle of Zuckerkandl. Following dissection and division of this layer, the recurrent laryngeal nerve will be seen to lie on the deeper layer, the more fibrous and denser true Ligament of Berry. At thyroidectomy, once the fibrous Ligament of Berry layer is divided, the recurrent laryngeal nerve relaxes and adopts a serpiginous course in the tracheoesophageal groove. The Ligament of Berry maybe in two layers with thyroid tissue between the two layers. Because of anteromedial rotation of the thyroid and larynx and trachea, the recurrent laryngeal nerve lies lateral to the Ligament of Berry and deep to the superficial vascular fascial layer. The recurrent laryngeal nerve thus lies between the two layers but does not pass through the Ligament of Berry.

Original languageEnglish
Title of host publicationThe Recurrent and Superior Laryngeal Nerves
EditorsGregory W. Randolph
PublisherSpringer
Pages103-113
Number of pages11
ISBN (Electronic)9783319277271
ISBN (Print)9783319277257
DOIs
Publication statusPublished - 27 May 2016

Keywords

  • Artificial genu and tensile stress within recurrent laryngeal nerve
  • Bifid recurrent laryngeal nerve
  • Extralaryngeal branching of recurrent laryngeal nerve
  • Ligament of berry
  • recurrent laryngeal nerve
  • Superficial vascular fascial layer
  • Tubercle of zuckerkandl

Cite this

Sritharan, N., Paddle, P. M., Snyder, S. K., & Serpell, J. W. (2016). The ligament of berry. In G. W. Randolph (Ed.), The Recurrent and Superior Laryngeal Nerves (pp. 103-113). Springer. https://doi.org/10.1007/978-3-319-27727-1_10
Sritharan, Niranjan ; Paddle, Paul M. ; Snyder, Samuel K. ; Serpell, Jonathan W. / The ligament of berry. The Recurrent and Superior Laryngeal Nerves. editor / Gregory W. Randolph. Springer, 2016. pp. 103-113
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Sritharan, N, Paddle, PM, Snyder, SK & Serpell, JW 2016, The ligament of berry. in GW Randolph (ed.), The Recurrent and Superior Laryngeal Nerves. Springer, pp. 103-113. https://doi.org/10.1007/978-3-319-27727-1_10

The ligament of berry. / Sritharan, Niranjan; Paddle, Paul M.; Snyder, Samuel K.; Serpell, Jonathan W.

The Recurrent and Superior Laryngeal Nerves. ed. / Gregory W. Randolph. Springer, 2016. p. 103-113.

Research output: Chapter in Book/Report/Conference proceedingChapter (Book)Otherpeer-review

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N2 - The last 2 cm of the extralaryngeal course of the recurrent laryngeal nerve is an area of critical anatomical importance. It is the site of greatest risk for neuropraxia, the site of development of the artificial genu and point of maximal tension within the recurrent laryngeal nerve at thyroidectomy and the site of bifurcation of the recurrent laryngeal nerve. In this last 2 cm segment, the Ligament of Berry which attaches the thyroid to the trachea is located. Two fascial layers are described in the region of the Ligament of Berry, covering the last 2 cm of the extralaryngeal course of the recurrent nerve. The more superficial layer, the superficial vascular fascial layer, contains branches of the inferior thyroid artery, the superior parathyroid gland, and the Tubercle of Zuckerkandl. Following dissection and division of this layer, the recurrent laryngeal nerve will be seen to lie on the deeper layer, the more fibrous and denser true Ligament of Berry. At thyroidectomy, once the fibrous Ligament of Berry layer is divided, the recurrent laryngeal nerve relaxes and adopts a serpiginous course in the tracheoesophageal groove. The Ligament of Berry maybe in two layers with thyroid tissue between the two layers. Because of anteromedial rotation of the thyroid and larynx and trachea, the recurrent laryngeal nerve lies lateral to the Ligament of Berry and deep to the superficial vascular fascial layer. The recurrent laryngeal nerve thus lies between the two layers but does not pass through the Ligament of Berry.

AB - The last 2 cm of the extralaryngeal course of the recurrent laryngeal nerve is an area of critical anatomical importance. It is the site of greatest risk for neuropraxia, the site of development of the artificial genu and point of maximal tension within the recurrent laryngeal nerve at thyroidectomy and the site of bifurcation of the recurrent laryngeal nerve. In this last 2 cm segment, the Ligament of Berry which attaches the thyroid to the trachea is located. Two fascial layers are described in the region of the Ligament of Berry, covering the last 2 cm of the extralaryngeal course of the recurrent nerve. The more superficial layer, the superficial vascular fascial layer, contains branches of the inferior thyroid artery, the superior parathyroid gland, and the Tubercle of Zuckerkandl. Following dissection and division of this layer, the recurrent laryngeal nerve will be seen to lie on the deeper layer, the more fibrous and denser true Ligament of Berry. At thyroidectomy, once the fibrous Ligament of Berry layer is divided, the recurrent laryngeal nerve relaxes and adopts a serpiginous course in the tracheoesophageal groove. The Ligament of Berry maybe in two layers with thyroid tissue between the two layers. Because of anteromedial rotation of the thyroid and larynx and trachea, the recurrent laryngeal nerve lies lateral to the Ligament of Berry and deep to the superficial vascular fascial layer. The recurrent laryngeal nerve thus lies between the two layers but does not pass through the Ligament of Berry.

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KW - Bifid recurrent laryngeal nerve

KW - Extralaryngeal branching of recurrent laryngeal nerve

KW - Ligament of berry

KW - recurrent laryngeal nerve

KW - Superficial vascular fascial layer

KW - Tubercle of zuckerkandl

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DO - 10.1007/978-3-319-27727-1_10

M3 - Chapter (Book)

SN - 9783319277257

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BT - The Recurrent and Superior Laryngeal Nerves

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Sritharan N, Paddle PM, Snyder SK, Serpell JW. The ligament of berry. In Randolph GW, editor, The Recurrent and Superior Laryngeal Nerves. Springer. 2016. p. 103-113 https://doi.org/10.1007/978-3-319-27727-1_10