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Related Experiment Video

Updated: Jun 18, 2026

Identification and Protection of the Recurrent Laryngeal Nerve during Transoral Robotic Thyroidectomy

Identification and Protection of the Recurrent Laryngeal Nerve during Transoral Robotic Thyroidectomy

Published on: October 24, 2025

Recurrent laryngeal nerve palsy after thyroid surgery.

Orhan Alimoglu¹, Murat Akdag, Bulent Kaya

¹First Department of Surgery, Vakif Gureba Training Hospital, Istanbul, Turkey. oalimoglu@yahoo.com

International Surgery

|December 1, 2009

Summary

Recurrent laryngeal nerve palsy after thyroidectomy is often temporary. Permanent vocal cord paralysis is more likely in patients undergoing reoperative thyroid surgery, highlighting a key risk factor.

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Area of Science:

Otolaryngology
Endocrine Surgery
Neurosurgery

Background:

Nerve injury, specifically recurrent laryngeal nerve palsy, is a significant complication following thyroidectomy.
Identifying risk factors for this nerve injury is crucial for patient safety and surgical outcomes.

Purpose of the Study:

To retrospectively analyze patients who developed recurrent laryngeal nerve palsy after thyroidectomy.
To identify potential risk factors and patterns associated with nerve injury, distinguishing between transient and permanent vocal cord paralysis.

Main Methods:

Retrospective analysis of 581 patients undergoing thyroidectomy.
Detailed review of 29 patients who developed recurrent laryngeal nerve palsy.
Categorization of palsy by laterality (unilateral/bilateral) and duration (transient/permanent).

Main Results:

29 of 581 patients (5%) experienced recurrent laryngeal nerve palsy.
Most cases (83%) were transient; only 5 patients (17%) had permanent paralysis.
Permanent paralysis was significantly associated with reoperative thyroid surgery.

Conclusions:

The majority of recurrent laryngeal nerve palsy post-thyroidectomy is transient.
Reoperative thyroid surgery represents a critical risk factor for permanent vocal cord paralysis.
Pre-operative laryngoscopy may detect some unilateral nerve injuries in patients with bilateral symptoms.