During thyroid surgery, the main manifestations of injury to the bilateral recurrent laryngeal nerve are that if the injury is mild, it may cause the patient to have hoarseness of voice. If the injury to the bilateral recurrent laryngeal nerve is more serious, it may cause the patient to lose his voice, and in serious cases, it may also cause the patient to have difficulty breathing or even to suffocate. Therefore, it must be treated in a timely manner to avoid causing asphyxia, resulting in threats to the patient’s life. If a laryngeal nerve injury is found, it should be repaired in a timely manner, and postoperative observation must be performed. If necessary, the patient should be advised to perform a tracheotomy to avoid breathing difficulties and even asphyxia. After the recurrent laryngeal nerve is restored, the tracheotomy incision will be closed and the patient will be advised to breathe on his own, and the patient’s breathing will be observed to avoid asphyxia.