[Monitoring the recurrent laryngeal nerve as a routine measure in thyroid gland surgery].

Intra-operative monitoring of the recurrent laryngeal nerve by electromyography of the inner laryngeal muscles facilitates the nerves preparation. The positive and negative predictive values of the method with regard to vocal cord function have not sufficiently been examined. Prospective randomized data concerning the usefulness with regard to permanent nerve palsy rates are lacking. The impressive reduction in palsy rates over the last 20 years is due to routine preparation and protection of the visualized nerve. This principle must not be abandoned. Depending on the setting, neuromonitoring may be a valuable help. It is not an obligation in thyroid surgery.