Identification of the recurrent laryngeal nerve by intraoperative neuromonitoring

301 patients underwent thyroid surgery in 1998 by using the intraoperative neuromonitoring. The documentation was done prospectively. The system of in traoperative neuromonitoring consists of a stimulation circuit and an elect romyographic record. We placed the deriving electrode transligamentally thr ough the cricothyroid membrane. By relaxometry we investigated the influenc e of the relaxation level on the electromyographic record of the vocal musc le. Using a standardized operative technique we found a side-related rate o f primary palsy of 2.3 % (n = 13), from which 61.5 % (n = 8) showed to be o nly temporary during a postoperative follow-up period. The intraoperative n euromonitoring with the purpose of identification of the recurrent laryngea l nerve is a safe and reliable method.