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.