How is injury to the superior laryngeal nerve during thyroidectomy characterized?

Updated: May 08, 2018
  • Author: Neerav Goyal, MD, MPH; Chief Editor: Arlen D Meyers, MD, MBA  more...
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The superior laryngeal nerve has both an internal and external branch. The internal branch provides sensory innervation to the larynx, while the external branch innervates the cricothyroid muscle. This posterior laryngeal muscle assists with lengthening of the vocal fold. Estimates of this complication vary, and are likely underestimated.

Often this injury is relatively asymptomatic. Patients may occasionally experience hoarseness or vocal fatigue. Voice professionals, however, can be significantly affected by this injury, as it affects the ability to produce higher-pitched sounds and thus may affect a singer’s upper register.

This injury too may be evaluated videostroboscopy, as well as laryngeal EMG. Some slight bowing of the affected vocal cord may be present, and the affected vocal cord may be lower than the normal cord. Additionally, EMG shows a deficit in the cricothyroid muscle.

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