How to Preserve Laryngeal Nerve for Preventing Post-Thyroidectomy Voice Change

After thyroid surgery, voice change occurs very frequently, in more than 30% of cases.In addition to injury to the recurrent laryngeal nerve (RLN) or the external branch of superior laryngeal nerve (EBSLN), vocal fold edema due to excessive tracheal traction or disrupted laryngeal venous drainage, and laryngotracheal fixation following injury to extralaryngeal musculature can cause post-thyroidectomy voice change.Although complete recovery can be expected mostly in 3 months, dysphonic patients should be evaluated pre and postoperatively by laryngoscopy or laryngeal stroboscopy.The present review discusses the evaluation of voice change, the anatomy of RLN and EBSLN and common cause of voice change after thyroid surgery.Furthermore, we represent how to preserve RLN, SLN including intraoperative nerve monitoring.