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. 2022 Feb 23;12:779621. doi: 10.3389/fonc.2022.779621

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Copyright © 2022 Yu, Li, Liu, Jiang, Liu, He, Wang and Wang

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Intraoperative nerve tunnel protecting (INTP) strategy was applied in open thyroidectomy. (A) Inferior pole of thyroid lobe was exposed, and the recurrent laryngeal nerve (RLN) was mapped by intraoperative neural monitoring (IONM) probe. (B) Expose one segment of RLN with clamps. (C) A tunnel was established along the direction of RLN with clamps. (D) Endoscopic gauze was stuffed in the tunnel and covered the surface of RLN. (E) Gauze protects RLN from thermal liquid–gas when harmonic scalpel (HS) was used to dissect non-neural tissues. (F) The “tunnel” was extended by a constant deepening of the gauze and gradually completed the separate pathway.