laryngoscopy, thyroid surgery and recurrent nerve lesions:who is to blame?

As a personal opinion, we do not perform routine VC assessment after thyroid surgery, for eithernociceptive stimulation and hemodynamic response, while we rather plan a protected extubationstrategy in all cases where a difficult intubation was observed or a difficult extubation might beexpected8. Finally, we would remark that despite controversial results, intraoperativeneuromonitoring in thyroidectomy represents today a standard of care9, and we further suggest thepotential role of ultrasounds which could be easily used to assess vocal cords before and aftersurgery in the context of a perioperative airway evaluation10.We should never forget that larynx and vocal cords are highly reactive and sensible structures, sowe do believe that the less we stimulate them and the lower the manipulation, the better will belaryngeal outcome in our patients.