Beahrs Triangle

Introduction:

Recurrent laryngeal nerve should be diligently sought after and preserved in every case of thyroid surgery. Damage to this nerve causes paralysis of vocal folds. Damage to recurrent laryngeal nerve on both sides during thyroid surgery is actually a disaster as the patient will have stridor.

Location of recurrent laryngeal nerve:

Anatomically the course of recurrent laryngeal nerve is highly variable. It is commonly sought in the tracheo oesophageal groove in between the branches of inferior thyroid artery.

The inferior thyroid artery is a branch of thyrocervical trunk on the right side. It enters the neck by piercing the prevertebral fascia medial to the carotid sheath to enter the posterior part of thyroid gland. During it makes sense to identify the recurrent laryngeal nerve before dividing the branches of inferior thyroid artery.

Most accurate and safe way of identifying the nerve is to seek it low down in the tracheo - oesophageal groove. Here it forms the third side of Beahr's triangle. This triangle is named after OH Beahrs. The other two sides of the triangle are formed by the common carotid and inferior thyroid arteries.