Dear Editor,

I read with interest the paper by Melin M et al., recently published in the World Journal of Surgery [1]. It is interesting to note the occurrence of delayed vocal cord palsy in four patients of this study. It would be of interest to know what is the opinion of the authors about the possible etiopathogenesis for this complication. Obviously, an injury of the recurrent laryngeal nerve will result in VCP immediately after surgery (use of diathermy?, use of hemostatic material in contact with the nerve causing granulomatous changes after some time?). I would also like to remind that the routine use of intraoperative neuromonitoring remains controversial; at this time of crisis, the cost is a parameter that should be taken seriously into consideration. I enjoyed reading the paper.