Neural monitoring in endocrine neck surgery

Recurrent laryngeal nerve (RLN) injury is the most dreaded complication in endocrine neck surgery. It can manifest as dysphonia, dysphagia, paroxysmal coughing, aspiration, or acute airway obstruction. A substantial proportion of patients (80%) undergoing thyroid surgery may complain of voice changes (1). RLN injury has been ranked among the leading reasons for malpractice lawsuits.