In the current thyroid surgery, the problem of laryngeal nerve protection has been troubling the majority of thyroid surgeons, although the emergence of the nerve detector is a good solution to the problem of laryngeal nerve protection, but because of the high price of the instrument and the use of high-value consumables, seriously restrict its use and promotion, according to personal work experience, the traditional laryngeal nerve search method is summarized as follows: 1, the upper approach method: if the gland If the lower nodes are large or have heavy adhesions with the surrounding tissues, and if the presence of the laryngeal nerve is highly suspected, the patient’s laryngeal nerve should be dissected after the upper pole of the thyroid is treated with the “decapitation” method, and then the corresponding laryngeal nerve should be dissected downward. However, there is often a small artery here, which should be carefully separated and ligated. At the same time, there is a venous plexus between the posterior pole of the thyroid gland and the corresponding hypopharyngeal muscle, so attention should be paid to the anatomical gap during surgery, and once bleeding occurs, do not blindly stop bleeding. The common reason for taking the superior approach is that the laryngeal nerve has more slender branches before entering the larynx, and the venous plexus in this area is easy to bleed, so do not blindly stop bleeding by choosing this approach. 2. Lateral approach: If a large thyroid mass occupies the entire thyroid lobe, if there are more enlarged lymph nodes in the tracheoesophagus, if there are large nodules in the superior thyroid gland or if the nodules are located in the posterior dorsal membrane of the superior pole, the lateral approach is generally used. During the operation, the middle thyroid vein is treated first, and the thyroid gland is lifted medially. During the process of revealing the nerve, the thyroid gland needs to be turned up and the inferior artery branches are fully revealed by the freeing under the palpation, and the recurrent laryngeal nerve crosses the inferior thyroid artery in most cases. Blind ligation of the vessels in this area may cause damage to the recurrent laryngeal nerve and result in postoperative hoarseness. In addition, because of the rich vascular network in the veins below the thyroid gland and the high brittleness of the tissues, it is easy to bleed during the separation operation and affects the nerve exposure, while the lateral side of the thyroid gland has a lesser vascular network of veins, which basically does not bleed during the separation operation, thus facilitating the exposure. If the thyroid gland is large and not easy to pull medially, the isthmus of the thyroid gland can be cut first, and the anterior tracheal space can be free, so that the pulling amplitude can be increased, and it is easy to find the recurrent laryngeal nerve. 3. Lower approach: If the swelling is located in the upper middle, middle and upper level of the thyroid gland with heavy adhesions to the surrounding tissues, the lower pole of the thyroid gland should be searched to expose the laryngeal nerve. The left side of the nerve is located close to the tracheoesophageal groove and is fixed; the right side is not fixed and tends to deviate outward, which makes it difficult to find and easy to damage; at the same time, the inferior pole of the thyroid gland has many accompanying vessels and is close to the inferior pole venous plexus, which makes it easy to bleed during the actual separation, but the laryngeal nerve has no branches here, so it is not difficult to distinguish it from the vascular branches. When the recurrent laryngeal nerve is exposed in this area, first ligate the thyroid gland and cut off the vascular branches, then free the lower pole of the thyroid gland to the middle and lower third of the gland. There are often two signs for finding the recurrent laryngeal nerve here, one is the inferior pole parathyroid gland and the other is the Zuckerkandl node; overall it is more difficult to reveal the nerve in the inferior approach because there is more tissue in the tracheoesophageal groove in the inferior pole of the thyroid gland.