Blumgart and his co-workers,1 at the Beth Israel Hospital in Boston, recently reported the therapeutic results of total ablation of the thyroid gland in patients with angina pectoris or congestive heart failure. Berlin,2 who developed and first described the operation, realized at the outset the danger of injury to the recurrent laryngeal nerves because of the intimate anatomic relation between the thyroid and these nerves. This relationship is particularly close just below the arch of the cricoid in the area of fixation of the thyroid to the trachea, which Berlin described as the "adherent zone." In this area the nerve often traverses strands of fascial tissues connecting the thyroid to the trachea and has a varying relationship to the inferior thyroid artery. Berlin and Lahey3 showed that the recurrent laryngeal nerve is more often anterior to the inferior thyroid artery on the right than on the left
FREEDMAN LM. TREATMENT OF ANGINA PECTORIS AND CONGESTIVE HEART FAILURE BY TOTAL ABLATION OF THE THYROID: V. IMPORTANCE OF LARYNGOSCOPIC EXAMINATION AS A MEANS OF PREVENTING BILATERAL PARALYSIS OF THE VOCAL CORDS. Arch Otolaryngol. 1934;19(3):383–386. doi:10.1001/archotol.1934.03790030091010
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