Recurrent laryngeal nerve paralysis is a much-dreaded complication of thyroid surgery.

Objective: To study the feasibility and the reliability of a recurrent laryngeal nerve monitoring technique.

Materials and methods: This was a prospective study including 36 patients proposed for thyroid surgery with recurrent laryngeal nerve monitoring. They underwent post-operative fibre-optic laryngeal examination and speech therapist consultation.

Results: Our technique of nerve monitoring showed a 98 per cent sensitivity and 86 per cent specificity.

Conclusions: Recurrent laryngeal nerve monitoring is a feasible and reliable technique. It can be used to avoid bilateral nerve injury and to increase the surgeon's confidence but not to replace a systematic nerve identification and a careful dissection.

Previously, the hypoglossal nerve has not undergone intra-operative monitoring during neck operations in which the nerve is at risk. As society becomes increasingly litigious, this may change. This study describes the technique and the microvoltages used in 10 patients for intra-operative stimulation of the hypoglossal nerve with the Magstim nerve stimulator. We confirm that the technique is possible, simple and safe, with minimal disturbance to the patient, anaesthetist and surgeon.