The main stage of recurrent laryngeal nerve research. The role of Leonardo da Vinci. 500 years memory.

  • Background.The history of thyroid surgery demonstrates the evolution of modern surgical techniques.

    Material and methods.Early development of thyroid surgery in Europe came from the School of Salerno, Italy, in the 12-13centuries. It includes using of a hot iron, setons, ligatures with often patient’s death.  The anatomy of the normal thyroid gland was understood through the work of Leonardo da Vinci.

    Results. The recurrent laryngeal nerve(RLN) was found as a branch of the vagus nerve witch descends into the thorax before rising up to reach the neck. Galen at first described the RLN in detail during the second century. He recognized in studies on the living pig that “if one compresses the nerve with the fingers or a ligature or …cuts the nerve, the pig stopped squealing”. Arabic medical literature also contains references to the RLN (Albucassis,1000A.D.). During the Renaissance, in 1503, Leonardo Da Vinci drew the first anatomical representation of the RLN. Vesalius, in 1543, produced excellent anatomical drawings of the RLN. J. Berry described the thyroid suspending ligament.  In 1904, A.A.Bobrov and his pupil A.A.Lezhnev reported on 106 thyroid operations under RLN visual control.  Since 1938, F.H.Lahey and his staff have performed every thyroidectomies with RLN dissection and decreased the rate of it injuries to 0.3%.   

    Conclusion.Da Vinci was the first who drew RLN. A.A. Bobrov, Lahey’s works with its emphasis on anatomy set the course and direction for modern thyroid surgery. RLN monitoring help us to perform thyroid surgery safely.

 

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