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Updated: May 30, 2026
05:25
Identification and Protection of the Recurrent Laryngeal Nerve during Transoral Robotic Thyroidectomy
Published on: October 24, 2025
Recurrent laryngeal nerve palsy in benign thyroid disease: can surgery make a difference?
Ram Moorthy1, Alistair Balfour, Jean-Pierre Jeannon
1Department of Otorhinolaryngology Head & Neck Surgery, Guy's and St Thomas Hospital NHS Foundation Trust, 3rd floor Southwark Wing, St Thomas' Street, London, SE1 9RT, UK.
Summary
Recurrent laryngeal nerve (RLN) palsy is rarely caused by benign multinodular goitre (MNG). Surgical removal of MNG can confirm diagnosis and potentially restore nerve function, offering hope for patients with this uncommon condition.
Area of Science:
- Otorhinolaryngology
- Head and Neck Surgery
- Endocrinology
Background:
- Recurrent laryngeal nerve (RLN) palsy typically suggests malignant thyroid disease due to nerve invasion.
- Paralysis of the RLN caused by benign thyroid conditions is exceptionally rare and infrequently documented.
Observation:
- This study retrospectively reviewed five female patients (age 32-81) with RLN palsy and benign multinodular goitre (MNG).
- Diagnostic evaluations included laryngoscopy, fine needle aspiration cytology, and CT scans.
- All patients underwent thyroidectomy with nerve integrity checks using a nerve stimulator.
Findings:
- Two out of five patients experienced recovery of RLN function post-thyroidectomy.
- Histological analysis confirmed benign multinodular goitres in all cases.
- RLN palsy associated with benign thyroid disease is a rare clinical presentation.
Implications:
- Careful patient evaluation is crucial to confirm RLN palsy and rule out malignancy before surgery.
- Thyroidectomy for benign MNG can aid in diagnosis and nerve preservation.
- Surgical intervention for MNG in patients with RLN palsy may lead to functional nerve recovery.
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