ANSA

An incision was made up to the lateral margin and the deep branches of the ansa cervicalis were identified and preserved.

Schwannoma of the ansa cervicalis is extremely rare and there have only been four reported cases in the literature.

The common carotid artery, vagus nerve and internal jugular vein were dissected to expose its relationship to the ansa cervicalis. The dissections were recorded using a Canon digital Powershot G5 camera (4x optical zoom).

Superior Laryngeal nerve, Recurrent Laryngeal nerve, Ansa cervicalis and hypoglossal nerve where identified and preserved.

The patient was taken to the operating room, where she underwent a left arytenoid adduction and reinnervation of the left recurrent laryngeal nerve (RLN) with a branch of the ansa cervicalis. Intraoperative evoked electromyography showed no activity in the vocalis muscle following stimulation of the left RLN, indicating a true paralysis.