Recurrent Laryngeal Nerve (RLN)
The critical nerve innervating the vocal cords that must be preserved during thyroid surgery; injury causes hoarseness or vocal cord paralysis.
The RLN is a branch of the vagus nerve that passes through the neck to innervate the intrinsic muscles of the larynx. Unilateral palsy causes hoarseness, aspiration and fatigue-related voice problems. Bilateral palsy may cause respiratory failure.
Intraoperative nerve monitoring (IONM) electrically stimulates the RLN during surgery to confirm its location and integrity. In experienced hands, unilateral RLN injury rates are below 1%.
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