The recurrent laryngeal nerve runs with the inferior thyroid aery toward the lower lobes of the thyroid, This means that the recurrent laryngeal nerve would be at risk in any surgery involving the inferior thyroid aery or the inferior poles of the thyroid. The recurrent laryngeal nerve becomes the inferior laryngeal nerve at the inferior border of cricopharyngeus, and this nerve continues on to innervate all the muscles of the larynx with the exception of cricothyroid. So, an injury to the recurrent laryngeal nerve might lead to hoarseness and difficulty breathing (due to a laryngeal spasm). .