A Microdissectional Study on Galen's Anastomosis: Anatomical Perspective with Clinical Emphasis

Purpose: Galen's anastomosis, which is placed over the dorsal surface of the posterior cricoarytenoid muscle, is formed by the internal branch of the superior laryngeal nerve and the dorsal branch of the recurrent laryngeal nerve (RLN). This study aims to contribute literature about the prevalence of Galen's anastomosis which is still a controversial issue and indicates the prevalence of this type of anastomosis in both sides of the larynx and indicate the importance of this anastomosis in different neck surgeries and procedures. Subjects and Methods: Twenty-two adult formalin-fixed hemilaryngeal (11 larynx) specimens' anatomical micro-dissection were performed on both sides (right-left) posteriorly. Every specimen consisted of larynx, trachea, epiglottis, and hyoid bone. Internal laryngeal nerve, recurrent laryngeal nerve, and inferior thyroid artery were freed up connective tissue to better analyze their relationship and to find their exact course with termination point. Results: In our current study, total Galen's anastomosis prevalence was found %54.53 with %27.27 right single trunk, %18.18 left single trunk, 4.54 left plexus formation, and 4.54 left double trunk. There has not been any anastomotic structure in %22.72 of the left side and in %22.72 of the right side microdissection of laryngeal specimens. Conclusion: During laryngeal or thyroid surgery, observation of an unknown intralaryngeal branching pattern may lead to confusion and may increase the risk of iatrogenic nerve injury, thus it is crucial to contribute to the literature about microanatomy and prevalence of Galen's anastomosis.