Palpatory method used to identify the recurrent laryngeal nerve during thyroidectomy

The major complication of thyroid surgery, occurring in 1% to 6% of cases, is injury to the recurrent laryngeal nerve (RLN). A simple method to identi fy the RLN during thyroid surgery is described by the authors. It consists in palpation of the nerve caudally to the inferior pole of the thyroid, aft er the nerve has been made taut by the upward and medial traction of the th yroid gland. This method was used on 47 human cadavers and 45 patients with benign thyroid diseases. It made it possible to identify the RLN in all of the cadavers and 52 of the 55 identifications during 45 thyroidectomies (i n 10 total thyroidectomies the identification was bilateral). Laryngeal mot ility was normal in all patients at postoperative laryngoscopy. Using the p alpation before dissection in the region of the inferior thyroid artery, th e traditional viewing method became easier and safer, reducing the risk of injury where it is most likely to occur to the nerve.