Abstract
Background
Recurrent laryngeal nerve (RLN) damage because of thyroid and parathyroid surgery has been recognized for over a century. Injury rates have been slowly decreasing in this period while effective treatment strategies have been increasing.
Methods
Recent literature was evaluated on the topics of anatomy, pathophysiology, avoidance, and conservative and surgical treatment of RLN injury. Data for this literature review were identified by PubMed and references from relevant articles using the search terms "thyroid," "laryngeal nerve," and "injury." Only articles published in English between 1990 and 2015 were included.
Results
Advances in technique and equipment have made injury less likely. The evidence and role for neuromonitoring is discussed. Treatment strategies may include speech therapy, vocal cord augmentation using injection, laryngeal framework surgery techniques (including laryngoplasty and arytenoid adduction), and reinnervation.
Conclusion
Injury rates in specialist centers are very low. Good to excellent results may be obtained in most cases.
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