Following thyroidectomy, the preservation of the recurrent laryngeal nerve is the gold standard. Visual identification of the recurrent laryngeal nerve is mandatory during thyroidectomy. That technique has decreased the rate of permanent palsy during thyroid or parathyroid surgery (1). However, the palsy can occur when using only the visualization of the nerve, even in experienced hands (2).
Intraoperative nerve monitoring is a common technique in ear surgery, used to permanently monitor the facial nerve. This technique can be used in the thyroid surgery as well. Intraoperative neuromonitoring of the recurrent laryngeal nerve represents an adjuvant technique, until the visual identification and functional confirmation of the nerve.