[Preservation of the recurrent laryngeal nerve]

A strategy to protect the inferior laryngeal nerve (ILN, recurrent and non-recurrent) as well as the superior laryngeal nerve (SLN) includes the reason for and extend of the operation to avoid recurrent goiter, selection of an experienced institution and operating team, a cautious intubation, adequate and anatomical operating technique, recognition of risk factors and postoperative treatment with a sufficient dosage of hormone and/or iodine. The ILN should be dissected routinely in view of its anatomical variation. The "capsular dissection technique" should be applied. The "laterialisation technique" of the upper pole protects the SLN with regard to its anatomic variability. Neuromonitoring of both nerves can be helpful under difficult circumstances.