Table 1. Preoperative (A) unpredictable and (B) predicable RLN risk situations. Atypical courses of the RLN are observed in approximately a quarter of the thyroid gland operations. Preoperatively unpredictable risk situations, which can only be detected intraoperatively, are one of the main reasons for using neuromonitoring not only selectively but also routinely. Furthermore, the surgical experience pertaining to the identification, exposure, and protection of the RLN has a demonstrable influence on the nerve paresis rates (9).
| No. | A. Unpredictable | B. Predicatable |
|---|---|---|
| 1 | Atypical RLN pattern | Previous neck surgery |
| 2 | RLN anterior to the thyroid gland | Previous radiotherapy |
| 3 | RLN fixed, splayed or entrapped | Cancer |
| 4 | RLN posterior to Berry ligament | Graves’ disease |
| 5 | Anteriorly located RLN to the Zuckerkandl’s tuberculum | Lymph node metastases |
| 6 | Branched RLN | Retrosternal goiter |
| 7 | Antevascular RLN | Thyroiditis |
| 8 | Thin RLN | |
| 9 | Invaded RLN | |
| 10 | Non-RLN |
RLN, recurrent laryngeal nerve.