Systematic Use of Recurrent Laryngeal Nerve Neuromonitoring Changes the Operative Strategy in Planned Bilateral Thyroidectomy

Background: One of the worst complications in thyroid surgery is bilateral recurrent laryngeal nerve paralysis, which can lead to transient or definitive tracheotomy. Methods: We implemented a strict standard operative procedure beginning in January 2010 and modified our operative procedure. In all patients undergoing bilateral operation, we begin with the largest side or with the cancerous/suspicious side without dissecting the contralateral...