The course taken by the vagus nerve differs between the right and the left sides. The left vagus nerve follows the carotid artery into the mediastinum crossing anterior to the aortic arch. The left recurrent laryngeal nerve arising from the vagal nerve just below the aortic arch loops medially under the aorta and ascends within the tracheoesophageal groove. The anterior bronchoesophageal artery supplies the left vagus nerve. The approximate length of the left recurrent laryangeal nerve is 12 cms. Considering the extra length and the distance the left recurrent laryngeal nerve has to travel, it is the common nerve affected by diseases / disorders / trauma etc.
Diagram of left recurrent laryngeal nerve
The recurrent laryngeal nerve has significant but varying relationship with the inferior thryoid artery. On the left side, the recurrent laryngeal nerve passes behind the inferior thyroid artery in 50% of the cases and anterior to the artery in 20% of cases and may lie in between the branches of the inferior thyroid artery in 30% of cases.
The left recurrent laryngeal nerve is more susceptible to injuries than the right because of its longer and more extensive course. It also lies superficial in the left tracheoesophageal groove.
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