Laryngeal nerves identifiction and preservation in thyroid surgery

The principles of head and neck surgery are based on identification and preservation as opposed to avoidance of important structures, these principles would set identification and preservation of the laryngeal nerves as standard in all thyroid surgery (Jonas and Bahr, 2000).The laryngeal nerves are at risk during thyroid surgery and several techniques have been described for their intraoperative identification to minimize potential damage (Khan et al., 1997).Iatrogenic injury of the Recurrent Laryngeal Nerve (RLN) is one of the most serious concerns in thyroid surgery and paralysis of the vocal cords may cause significant voice and respiratory difficulties that limit a patient quality of life, complications of unilateral recurrent laryngeal nerve paralysis include dysphonia, susceptibility of aspiration pneumonia, cardiac stress and ventilatory disturbance in the form of airway resistance (Khan et al., 1997).Bilateral paralysis can be life threatening because of acute airway obstruction (Steinivason et al., 1998).