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Updated: Jul 18, 2026
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Identification and Protection of the Recurrent Laryngeal Nerve during Transoral Robotic Thyroidectomy
Published on: October 24, 2025
[Preventing recurrent laryngeal nerve lesions by anastomosing it during thyroid surgery]
Shicai Chen1, Hongliang Zheng, Shuimiao Zhou
1Department of Otorhinolaryngology-Head and Neck Surgery, Changhai Hospital, Second Military Medical University, Shanghai, 200433, China.
Lin Chuang Er Bi Yan Hou Ke Za Zhi = Journal of Clinical Otorhinolaryngology
|December 6, 2006
Summary
Anastomosing the recurrent laryngeal nerve (RLN) during thyroid surgery can prevent nerve damage. This technique, when applied appropriately, significantly reduces the risk of RLN lesions compared to standard protection methods.
Area of Science:
- Surgical Innovation
- Nerve Preservation
- Thyroid Surgery
Background:
- Recurrent laryngeal nerve (RLN) injuries are a significant complication of thyroid surgery.
- Standard surgical techniques aim to protect the RLN but do not eliminate the risk of damage.
Purpose of the Study:
- To evaluate the efficacy of recurrent laryngeal nerve (RLN) anastomosis in preventing nerve lesions during thyroid surgery.
- To determine if direct nerve repair (anastomosis) is superior to conventional nerve protection.
Main Methods:
- A comparative study involving 517 patients undergoing thyroid surgery.
- Group A (163 patients): Recurrent laryngeal nerves (RLNs) were anastomosed (partially or totally).
- Group B (354 patients): RLNs received standard protection without anastomosis.
Main Results:
- No recurrent laryngeal nerve (RLN) injuries were observed in the anastomosis group (Group A).
- The standard protection group (Group B) experienced 3 RLN injuries (0.7% lesion rate).
- The rate of RLN lesion was significantly lower in the anastomosis group.
Conclusions:
- Anastomosing the recurrent laryngeal nerve (RLN) during thyroid surgery is an effective method for preventing nerve lesions.
- The extent of RLN anastomosis should be tailored to the specific thyroid pathology.
- RLN anastomosis may not be necessary for benign thyroid conditions distant from the tracheoesophageal groove.
