Objective: To investigate the efficacy of recurrent laryngeal nerve (RLN) exposure in preventing RLN injury during thyroid surgery.
Methods: Using a prospective， randomized， controlled design， 373 patients scheduled to undergo thyroid surgery and met the inclusion criteria were randomly divided into observation group and control group. The patients of the observation group (173 cases) underwent thyroid surgery with RLN exposure， while the patients of the control group (200 cases) underwent thyroid surgery without RLN exposure. The RLN injury rate and outcome of the two groups were compared.
Results: A total of 198 RLNs were exposed in observation group with the RLN injury rate of 0.5% (1/198)， and the nerve injury recovered within 6 months. The RLN injury rate of the control group was 6.0% (12/200). Of the patients with RLN injury， 4 cases partially recovered within 6 months and 8 cases were permanent injury. There were significant differences of RLN injury between the two groups (P＜0.05).
Conclusions: The routine exposure of RLN pathway during thyroid surgery can effectively reduce the incidence of RLN injury.