Identification and monitoring of the recurrent laryngeal nerve during thyroidectomy

Careful dissection of the recurrent laryngeal nerve (RLN) represents perhaps the most critical component of thyroidectomy. It long has been established that routine identification of the nerve reduces the risk of iatrogenic injury. In recent years, much attention has been paid to the role that functional monitoring plays in identification and preservation of the RLN. This article explores methods for detecting and identifying the RLN. It then examines the evolution of functional RLN monitoring, its potential advantages and disadvantages, statistical validity, and its role in the current medicolegal climate.