The recurrent laryngeal nerve in thyroid surgery

The recurrent laryngeal nerve (RLN) is an essential nerve for phonation and psychosocial interaction. Throughout the annals of laryngological history, vocal cord paralysis has been a well recognised disorder. A rich heritage of scientific investigation and research has considered the complexity of vocal cord function, laryngoscopic presentation and surgical rehabilitation. Identification and preservation of the RLN is the major concern in thyroid surgery. Controversy exists regarding the correct pre- and postoperative management in vocal cord evaluation. We fully review this topic and challenge, in part, the recent Thyroid Clinical Guidelines as published by RCSI.