Between November, 1996 and May, 1997 a series of 100 consecutive unselected patients undergoing all types of thyroid surgery – including even those inducing large dead space e.g. substernal goitre and carcinoma thyroid with recurrent nerve dissection – were randomly allotted to either receive drainage (n = 43) or not (n = 57). Patients with cervical dissection for lymph node metastasis were not included. Severe intra-operative haemorrhage was not a reason for exclusion. No complications such as haematoma or seroma were found in the undrained group whereas only minor complications such as haematoma (n = 4) were noted in the drained group. Whatever the group, none of the patients required reexploration. The difference in overall hospital stay (1.72 days in the group of undrained patients versus 2.09 days in the drained group) was not statistically significant.

Our experience with a non-invasive, disposable electrode for intra-operative identification and monitoring of the recurrent laryngeal nerve is described. The electrode system, while simply attached to the endotracheal tube, acts as a laryngeal surface electrode and detects electromyographic activity of the intrinsic laryngeal muscles when the recurrent laryngeal nerve is stimulated. We have successfully used this electrode to monitor 19 recurrent laryngeal nerves in 15 patients who have undergone partial or total thyroidectomy. We feel that this device can be useful particularly in cases of re-exploration and malignancies of the thyroid gland.