Objective: To explore the safe approach to routine exposure of the recurrent laryngeal nerve in thyroid surgery.
Methods: A total of 1974 sides of laryngeal nerves were exposed in 1458 thyroid surgeries, which included six right side non-recurrent laryngeal nerves. Ninety seven percent (1915 sides of the laryngeal nerves) were exposed through inferior thyroid artery way. The rest were exposed through nerve entrance way (38 sides, 1.9%) or isthmus-to-tracheoesophageal groove way (21 sides, 1.1%).
Results: Permanent injury of recurrent laryngeal nerves occurred in seven cases, which comprised 0.5% of the total surgeries. Transient injury of recurrent laryngeal nerves occurred in 24 cases, which comprised 1.6% of the total surgeries.
Conclusion: Routine exposure of recurrent laryngeal nerve in thyroid surgery is safe. The exposure should be started from the inferior thyroid artery and be ended at the nerve entrance into laryngeal.