Abstract: Background and purpose: A non-recurrent course is a rare anatomic variation of the recurrent laryngeal nerve, which is highly predisposed to injury in thyroidectomy. The study was to summarize preoperative judgment and injury prevention of non-recurrent laryngeal nerve (NRLN) during thyroidectomy. Methods: Preoperative diagnosis and precautions during thyroidectomy were investigated, clinical data from eleven cases of NRLN were analyzed and related literature was reviewed as well. Results: All eleven cases were NRLN of type 1. Among those, the right subclavian artery was found posteriorly to the trachea and esophagus shown by preoperative CT in seven cases. One case who had NRLN injury underwent nerve anastomosis. Conclusion: NRLN is a rare anatomical variation. Preoperative neck CT scan identifies presence of a NRLN, which may reduce the incidence of nerve injures by using intraoperative capsular dissection.

Key words: Thyroidectomy, Recurrent laryngeal nerve, Non-recurrent laryngeal nerve