Superior laryngeal nerve paralysis and benign thyroid disease.

A case of an isolated superior laryngeal nerve paralysis from a thyroid adenoma is presented. Superior laryngeal nerve paralyses should be sought, particularly in the preoperative and postoperative examination of thyroidectomy patients. Symptoms of a change in vocal strength or pitch and aspiration along with the laryngoscopic findings of a glottis posteriorly rotated toward a bowed vocal cord are diagnostic. Surgical trauma to the superior laryngeal nerve, though a risk of any thyroidectomy, usually can be avoided if one knows its possible anatomic variations and meticulously dissects the superior thyroid pole and its vessels.