Intraoperative monitoring of the recurrent laryngeal nerve during revision thyroid surgery.

Reoperation for recurrent or persistent thyroid cancer presents a challenge for the head and neck surgeon. Scarring, edema, and friability of the tissues together with distortion of the landmarks make reoperative thyroid hazardous. Meticulous surgical dissection with identification of the recurrent laryngeal nerve is of paramount importance. Intraoperative neuromonitoring is useful in reoperative thyroid surgery especially in situations where the anatomic situation diverges from the normal. Intraoperative neuromonitoring may reduce the morbidity of reoperative thyroid surgery.