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The photos show the beginning of the left and right recurrent laryngeal nerve (RLN or nervus laryngeus recurrens=NLR) where it branches from the vagus nerve and bends upwards. Damage to the RLN can lead to vocal cord paralysis and hoarseness. Common causes are: 1) surgery in the affected area, especially thyroid surgery and carotid endarterectomy, and 2) compression due to space-consuming processes, such as lung, thyroid or esophageal tumors. Compression by dilation of the left atrium or pulmonary artery in mitral stenosis, heart failure or pulmonary hypertension can also damage the RLN. Around which artery does the left resp. right RLN curve, and which side has the greatest chance of being damaged? Gosh A, Chaudhury S, 2019. Cadaveric Measurements of the LeftRecurrent Laryngeal Nerve, LigamentumArteriosum, Aortic Arch, and PulmonaryArtery in the Thorax with Clinical Implications... Myssiorek D. 2004. Recurrent laryngeal nerve paralysis- anatomy and etiology. Otolaryng Clin N. America
After an esophageal resection, beige-white milky fluid comes out of the chest drain. The liquid appears to contain many chylomicrons and lymphocytes. What is likely the cause?
