Laryngeal nerve morbidity in 1.273 central node dissections for thyroid cancer.

•Prevalence and mechanism of recurrent laryngeal nerve (RLN) injury during central neck dissection (CND) for cancer in 1.273 nerves at risk.•Stratifying by step of operation most lesions occurred while performing thyroidectomy.•By mapping the RLN using stimulation, a disrupted point was identified in 76% and 87% respectively for thyroidectomy and CND.•Nerves were injured in all cervical RLN course without any major location for CND; for thyroidectomy most nerves were injured in the distal 1 cm.•In CND, there was different distribution of causes: traction, entrapment and thermal (25%), ligation (12,5%).