338ANATOMICAL VARIATIONS AND BRANCHING PATTERNS OF THE RECURRENT LARYNGEAL NERVE: INSIGHTS FROM ANTERIOR NECK SURGERY STUDIESThe recurrent laryngeal nerve (RLN) is vital for the innervation of laryngeal muscles, making a thorough understanding of its anatomy crucial for surgeons, particularly during thyroid and parathyroid procedures where nerve damage can lead to serious complications. This study investigated the branching patterns and anatomical associations of the RLN and its terminal branches in 35 adult human larynges. A total of 70 RLNs were carefully dissected with emphasis on their relationship to the cricoid cartilage. The results demonstrated that in 89% of specimens, the RLN bifurcated below or adjacent to the lower edge of the cricoid cartilage, with branch separations ranging between 1 and 10 mm. The inferior laryngeal nerve (ILN), arising from the RLN at this boundary in 74% of cases, displayed 3 to 7 intralaryngeal branches, most commonly 4 to 5. Branches to the anterior cricoarytenoid muscle consistently originated from the posterior cricoarytenoid trunk near the lateral margin of the cricoid cartilage. The majority of lateral branches were found to emerge from the middle (48%) and lower (45%) thirds of the cricoid cartilage’s lateral margin. Branches supplying the oblique and transversal arytenoid muscles were less common (7%), predominantly arising from a single branch (91%). The RLN branches traveled adjacent to the cricoid lamina, dividing into smaller branches after entering the muscle tissue. Single ILN branches primarily originated from the upper and middle thirds of the lateral cricoid margin (92%), with smaller proportion (8%) showing two-branch origins. Upon penetrating the thyroarytenoid muscle, multiple fine branches were observed, illustrating a complex pattern of innervation. This comprehensive anatomical analysis resolves existing debates regarding RLN branching patterns and provides valuable information to enhance surgical accuracy and improve nerve reinnervation techniques. The precise delineation of nerve origins and their distribution zones offers critical guidance for surgeons to minimize the risk of inadvertent nerve injury, ultimately improving clinical outcomes in head and neck surgeriesSonarkhan@gmail.comResearch922019Human, Surgery, Laryngeal Nerve, ThyroidDr. Sonarkhan Deesha DevidasAssociate Professor, Department of Anatomy, Sree Balaji Medical College & Hospital, Chennai – 600044, Tamil Nadu, India