The recurrent laryngeal nerve (RLN) is the most important structure to protect during thyroid surgery. Here is how it is kept safe.
What is the RLN?
A branch of the vagus nerve that controls the vocal cord. It runs immediately behind the thyroid lobe.
Why injury risks voice
Damage causes ipsilateral vocal cord paralysis — and bilateral injury can affect the airway, though this is exceptionally rare.
How surgeons protect it
Routine visual identification, capsular dissection technique, judicious use of energy devices and — in selected cases — intraoperative nerve monitoring.
Pre-op laryngoscopy
Recommended where there is any pre-existing voice change or for re-do surgery.
Outcomes
Temporary dysfunction in around 5%; permanent injury well under 1% with experienced surgeons.
Frequently Asked Questions
Related Topics
recurrent laryngeal nerve
thyroid surgery safety