Less than four in 100 patients (four percent) suffer from hoarseness after thyroid surgery today. This is down from around 20 percent in the 1950s and 60s. The reason for this change? Surgeons have learned how to avoid damage to the recurrent laryngeal nerve (RLN).

Thyroid surgery used to pull on the nerve or cut off its blood supply. The result was hoarseness, difficulty swallowing, and even inhaling and choking on food.

Today the surgeon finds the nerve and protects it from damage during the thyroid removal. The experience of the surgeon is still a key factor. The operation is more difficult if a tumor is wrapped around the thyroid or involves the nerve.