To study the anatomic feature and exposing methods of recurrent laryngeal nerve(RLN) in thyroid surgery and to reduce the RLN injury.

The data of nine hundred and sixty-five cases were analyzed retrospectively, who were operated with total lobectomies. All RLNs were anatomically exposed, the resection part was chosen for the diseases' feature, and the anatomic feature and injury of RLN were discussed.

One thousand and fifty-two RLNs were exposed, including 721 nerves of right side and 331 nerves of left side, 87 nerves in both sides. 86 nerves were by superior exposure, 661 by lateral exposure, and 305 nerves by inferior exposure. Among all nerves, 461 went along the tracheoesophageal groove and 260 nerves deviated it in right, 285 went along it and 46 nerves deviated it in left, 687 RLNs (65.3%) had branches into laryngeal, 365 RLNs (34.7%) had no branches, and two non-recurrent laryngeal nerves were found in these cases. It took (6.7±0.54) minutes on average to reveal nerves. Eleven cases had temporary postoperative nerve injuries, 2 had permanent nerve injuries, and all cases improved for the other vocal cord surpassed compensation after 6 months.

To realize the anatomic feature of RLN, to use the different routes to reveal the RLN and to expose every RLN are very useful for avoiding the injury of RLN.