Preservation of the superior laryngeal nerve without neuromonitoring during thyroid surgery

Recently, Intraoperative neurophysiological monitoring (IONM) has enabled the prevention of nerve injury, reducing the incidence of complications associated with nerve injury even in high-risk surgeries. However, reliance on IONM is not feasible in all situations. Therefore, surgeons have the necessity and obligation to master the techniques for identifying and preserving nerves without the aid of neurophysiological monitoring. Therefore, it aims to introduce the course and variations of the superior laryngeal nerve, as well as methods for identifying and preserving the external branch of the superior laryngeal nerve during thyroid surgery without the use of intraoperative neurophysiological monitoring.