title: Management of unilateral recurrent laryngeal nerve injury after thyroid surgery: A review.
abstract: Recurrent laryngeal nerve (RLN) damage because of thyroid and parathyroid surgery has been recognized for over a century. Injury rates have been slowly decreasing in this period while effective treatment strategies have been increasing.
  
  
  
  Recent literature was evaluated on the topics of anatomy, pathophysiology, avoidance, and conservative and surgical treatment of RLN injury. Data for this literature review were identified by PubMed and references from relevant articles using the search terms "thyroid," "laryngeal nerve," and "injury." Only articles published in English between 1990 and 2015 were included.
  
  
  
  Advances in technique and equipment have made injury less likely. The evidence and role for neuromonitoring is discussed. Treatment strategies may include speech therapy, vocal cord augmentation using injection, laryngeal framework surgery techniques (including laryngoplasty and arytenoid adduction), and reinnervation.
  
  
  
  Injury rates in specialist centers are very low. Good to excellent results may be obtained in most cases.
authors.affiliation: Specialist Registrar in General Surgery, Chelsea and Westminister Hospital, London, United Kingdom.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Lynch
authors.affiliation: Department of Endocrine Surgery, National University Hospital, Lower Kent Ridge Road, Singapore.
authors.forename: Rajeev
authors.identifier: 0000-0002-3318-0357
authors.initials: R
authors.lastname: Parameswaran
mesh_terms: D004576:Electromyography / Q000379:methods; D005260:Female; D006801:Humans; D058753:Laryngoplasty / Q000379:methods; D008297:Male; D016343:Monitoring, Intraoperative / Q000379:methods; D011379:Prognosis; D061226:Recurrent Laryngeal Nerve Injuries / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D018570:Risk Assessment; D012720:Severity of Illness Index; D013070:Speech Therapy / Q000379:methods; D013965:Thyroidectomy / Q000009:adverse effects* / Q000379:methods; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy*
keywords: palsy; recurrent laryngeal nerve; surgery; thyroid