To compare the clinical outcome of two surgical methods of exposing recurrent laryngeal nerve (RLN) in thyroidectomy.

The clinical data of 80 patients underwent thyroidectomy were analyzed retrospectively. According to the surgical methods, 40 cases were divided into the fine group who received the fine tunica anatomy with exposing the RLN in the cricothyroid space, while 40 cases were divided into the conventional group who received the conventional surgical exposure of RLN under the inferior thyroid artery. Statistical analysis were performed by using SPSS 23.0 software. Measurement data such as intraoperative and postoperative indexes, serum parathyroid hormone (PTH) and Ca²⁺ level before and after surgery were expressed as (±), and were examined by using t test. The incidence of complications such as parathyroid and RLN injury were examined by using χ² test. A P value of <0.05 was considered as statistically significant difference.

There were no significant difference between the fine group and the conventional group in terms of the operation time, intraoperative blood loss, pain score, drainage volume and the length of hospitalization (P>0.05). There was no significant difference between the two groups in terms of serum PTH and Ca²⁺ levels before operation (P>0.05), however the PTH and Ca²⁺ levels in the conventional group were significantly lower than those in the fine group after operation respectively (P<0.05). Compared with the fine group, the incidence of temporary parathyroid injury of 10% and RLN injury of 7.5% in the conventional group were significantly higher (P<0.05).

Both two surgical methods of exposing RLN in thyroidectomy could achieve good therapeutic effect, but the fine tunica anatomy with exposing the RLN in the cricothyroid space could reduce the incidence of temporary RLN and parathyroid injury after surgery.