Optimal Management of Acute Recurrent Laryngeal Nerve Injury During Thyroidectomy

Abstract

Recurrent laryngeal nerve (RLN) injury is commonly encountered by thyroid surgeons and may carry with it great morbidity. Whether the injury is accidental or due to deliberate resection for oncologic soundness, the surgeon must be prepared to offer the best available treatment to patients, either at the time of injury or early in the recovery process. We review advances in treatment that allow optimal management of an acute RLN injury: ansa cervicalis–RLN reinnervation, in-office unsedated vocal fold injection augmentation, and electromyographic prognostication. The benefits and advantages of each procedure as well as relevant anatomy and techniques are delineated.