Related Experiment Video
Updated: Aug 29, 2026

Identification and Protection of the Recurrent Laryngeal Nerve during Transoral Robotic Thyroidectomy
Published on: October 24, 2025
Revisited anatomy of the recurrent laryngeal nerves
Guglielmo Ardito1, Luca Revelli, Lucia D'Alatri
1Department of Surgery, Catholic University of Sacred Heart, Rome, Italy. arditog@libero.it
Background:
The most frequent postthyroidectomy complication is recurrent laryngeal nerve (RLN) damage with subsequent vocal cord palsy.
Methods:
We have undertaken an intraoperative study aimed to determine the course, distribution, and RLN's anatomical relationships with adjacent structures. Only its identification and its careful exposure allow prevention of iatrogenic injuries.
Results:
The RLN was always routinely exposed and identified in 1,543 thyroidectomies. All patients underwent laryngoscopic evaluation before surgery and at the time of discharge. A total of 2,626 RLN were observed. The number of nerves exposed to risk was 673 (25.6%). In the whole series, of 2626 nerves controlled, there were 11 (0.4%) permanent palsies.
Conclusions:
Our study confirms that damage to the RLN or to one of its branches may be avoided only by identification and careful exposure of the nerve itself. An experienced surgeon with good knowledge of the anatomy of the RLN and its anatomical variations is required for uncomplicated treatment of thyroid disease.
Related Concept Videos
Larynx
Anatomy of the Larynx
The larynx consists of various components, including cartilage, muscles, and vocal cords. Its structure includes three large unpaired cartilages—the thyroid, cricoid, and epiglottis—and three smaller paired cartilages—the arytenoids, corniculates, and...
Cranial Nerves: Overview and Anatomy
Cranial Nerves: Types Part II
Facial Nerve (Cranial Nerve VII)
Cranial nerve VII, or the facial nerve,...
Anatomy of Respiratory System I: Upper Respiratory Tract
Nose and nasal cavity
The nose and nasal cavity represent the main external openings of the respiratory tract.
Pharynx
Nasopharynx
The nasopharynx, bordered by the conchae of the nasal cavity, serves exclusively as an air conduit. In its superior region, the pharyngeal tonsils or adenoids are located. These tonsils are clusters of lymphoid reticular tissue akin to a lymph node. The precise...
Spinal Nerves: Anatomy
There are 31 bilateral pairs of spinal nerves, each emerging from the spinal cord through the intervertebral foramina—openings between adjacent vertebrae. These nerves are...

