Vol. 2 No. 2 (2023): infermieristica journal: with you, not aganist

Intraoperative monitoring of the recurrent laryngeal nerve in thyroid gland surgery

Niccolo' Fagni
Department of Experimental and Clinical Medicine-Section of Anatomy and Histology University of Florence
Giacomo Gelati
Department of Experimental and Clinical Medicine-Section of Anatomy and Histology University of Florence
Cristiana Veltro
Department of Experimental and Clinical Medicine-Section of Anatomy and Histology University of Florence
Ferdinando Paternostro
DMSC University of Florence

Published 2023-07-31


  • Thyroid Surgery,
  • Recurrent Laryngeal Nerves,
  • Neuro-monitoring


In Thyroid surgery, the two novel approaches are the trans-axillary Robotic thyroidectomy and the trans-oral and sub-chin techniques.
During these surgical approaches is mandatory to recognise the Anatomy. The lower laryngeal nerves originate from the X cranial nerve (vagus nerve) and innervate all the intrinsic muscles of the larynx except for the cricothyroid muscles (which are innervated by the superior laryngeal nerve instead). The "recurring" name is due to the course in the opposite direction to the nerve of origin.
Neuro-monitoring of recurrent laryngeal nerves is the most important of the recent technological innovations. However it is of fundamental importance for the operator to remember that this method does not prevent recurrent nerve injury. On the other hand a two stage thyroidrctomy can avoid a tracheostomy thanks to neuro-monitoring.


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