title: Place and value of the recurrent laryngeal nerve (RLN) palpatory method in preventing RLN palsy during thyroid surgery.
abstract: BACKGROUND
  In recent years, certain publications have appeared confirming that intraoperative palpation of the recurrent laryngeal nerve (RLN) is a very reliable method.
  
  
  METHODS
  The characteristics of the surgical anatomy of 1023 RLN have been summarized on the basis of intraoperative palpability, running down, branching variations, thickness, and laryngeal entry site.
  
  
  RESULTS
  Palpation was helpful in 81.4% (833/1023), proved false positive in 8.2% (84/1023), and in 10.4% (106/1023) it was of no help in the exact localization. Definitive RLN palsy was experienced in 0.78% of all cases (8/1023), while transient paresis was encountered in 1.2% (12/1023). Only a moderately strong stochastic correlation could be found between RLN palsies and those nerves which were nonpalpable and atypical, which showed the joint occurrence of being both thinner than normal and branching already before the plane of the inferior thyroid artery (Cramer's associate coefficient, C = 0.383).
  
  
  CONCLUSIONS
  Palpation alone cannot substitute visualization and proper surgical dissection of the nerve.
authors.affiliation: Department of Surgery, St. George University Teaching Hospital, Seregélyesi út 3, H-8000 Székesfehérvár, Hungary. altorjay@mail.fmkorhaz.hu
authors.forename: Aron
authors.initials: A
authors.lastname: Altorjay
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Tihanyi
authors.forename: Ferenc
authors.initials: F
authors.lastname: Luka
authors.forename: Arpád
authors.initials: A
authors.lastname: Juhász
authors.forename: Zsuzsanna
authors.initials: Z
authors.lastname: Bencsik
authors.forename: Miklós
authors.initials: M
authors.lastname: Rüll
authors.forename: Gábor
authors.initials: G
authors.lastname: Kecskés
authors.forename: Balázs
authors.initials: B
authors.lastname: Paál
mesh_terms: D005260:Female; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D010173:Palpation; D012009:Recurrent Laryngeal Nerve / Q000033:anatomy & histology*; D061226:Recurrent Laryngeal Nerve Injuries; D013965:Thyroidectomy / Q000009:adverse effects* / Q000379:methods; D014826:Vocal Cord Paralysis / Q000209:etiology / Q000517:prevention & control*