Non-Recurrent Inferior Laryngeal Nerve Associated with Poland Syndrome: A Case Report

Thyroid surgery in Poland syndrome patients carries an elevated risk because the congenital vascular anomalies that define the syndrome can give rise to a non-recurrent laryngeal nerve (NRLN). We report the first documented case of right-sided NRLN detected during thyroidectomy in a patient with Poland syndrome. A 64-year-old man with Poland syndrome (absent right pectoralis major/minor) presented with a 4 cm right thyroid nodule. Pre-operative CT revealed a right-sided aortic arch. During right hemithyroidectomy, a Type I b NRLN was identified and preserved with intraoperative neuromonitoring. Post-operative recovery was uneventful; the patient remained free of hoarseness or aspiration at 3-month follow-up. This case establishes Poland syndrome as an additional clinical red flag for NRLN and advocates routine pre-operative CT or ultrasound mapping and intraoperative neuromonitoring in such patients. Recognizing this association prospectively can reduce nerve injury, improve voice outcomes, and inform safer surgical planning.