Which nerves are at risk during thyroidectomy?

Which nerves are at risk during thyroidectomy?

• A. Both left and right recurrent laryngeal nerves
• B. Right recurrent laryngeal nerve
• C. Left recurrent laryngeal nerve
• D. Accessory nerve

Answer: (A)

The main idea is that the recurrent laryngeal nerves lie in the tracheoesophageal groove and run very close to the thyroid gland and its inferior thyroid vessels. Because thyroidectomy involves dissecting near these structures, both the left and right recurrent laryngeal nerves are at risk. Each nerve supplies most intrinsic muscles of the larynx (except the cricothyroid), so injury can cause vocal cord paralysis and hoarseness. The right nerve loops around the subclavian artery and the left around the aortic arch before ascending in that groove to the larynx, which is why they are both vulnerable during thyroid surgery. In contrast, the accessory nerve travels in the posterior neck and is not a primary concern during standard thyroidectomy. Therefore, both recurrent laryngeal nerves being at risk is the correct concept.

The main idea is that the recurrent laryngeal nerves lie in the tracheoesophageal groove and run very close to the thyroid gland and its inferior thyroid vessels. Because thyroidectomy involves dissecting near these structures, both the left and right recurrent laryngeal nerves are at risk. Each nerve supplies most intrinsic muscles of the larynx (except the cricothyroid), so injury can cause vocal cord paralysis and hoarseness. The right nerve loops around the subclavian artery and the left around the aortic arch before ascending in that groove to the larynx, which is why they are both vulnerable during thyroid surgery. In contrast, the accessory nerve travels in the posterior neck and is not a primary concern during standard thyroidectomy. Therefore, both recurrent laryngeal nerves being at risk is the correct concept.