Cost analysis of intraoperative neural monitoring

The recurrent laryngeal nerve (RLN) injury represents one of the most feared complications during thyroidectomy (1). These injuries may cause a temporary or permanent palsy of the RLN and occur, more frequently, monolaterally. If only one side is involved, the palsy results in voice changes, hoarseness, or breathing trouble; in bilateral cases, instead, patients can undergo a potentially fatal airway obstruction needing an urgent tracheostomy (1). This complication, affects the quality of life of the patients, increases the charges for health care, and is the most frequent plea of lawsuits against thyroid surgeons.