How are injuries to the superior laryngeal nerve (SLN) due to thyroid surgery diagnosed?

Updated: Feb 27, 2020
  • Author: Pramod K Sharma, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Diagnosing an SLN injury with indirect or fiberoptic laryngoscopy is difficult. Posterior glottic rotation toward the paretic side and bowing of the vocal fold on the weak side may be noted. In addition, the affected vocal fold may be lower than the normal vocal fold.

Use of videostroboscopy and laryngeal EMG has enhanced the ability of otolaryngologists and speech pathologists to diagnose SLN paralysis. Videostroboscopy demonstrates an asymmetric, mucosal traveling wave. EMG demonstrates cricothyroid muscle denervation.

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