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A D V E R T I S E M E N T
A D V E R T I S E M E N T
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The mechanism of cricothyroid function is shown. The loss of this function may not be appreciated in normal speech, but can have a profound effect on the higher registers of the singing voice and on endurance. Unilateral superior laryngeal nerve dysfunction may be partially compensated for by the opposite muscle in normal speech, but not in singing.
A D V E R T I S E M E N T
The superior laryngeal nerve lies between the carotid artery and larynx before the internal branch penetrates the thyrohyoid membrane. The external, motor branch runs with the superior thyroid artery. In most (80%) individuals it separates from the artery about 1 cm above the superior pole of the thyroid (arrow) before reaching the cricothyroid muscle. It is critical to secure the branches of the superior thyroid artery right on the gland during thyroidectomy to avoid injuring the nerve, especially in those individuals whose nerves do not diverge.
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A D V E R T I S E M E N T
The right recurrent laryngeal nerve courses back beneath the right subclavian artery, and the left turns beneath the aorta beyond the ligamentum arteriosum. Rarely (1%) there is a non-recurrent right nerve that arises at the level of the thyroid cartilage and runs directly to the larynx. In such cases there is usually an aberrant right subclavian artery arising as the fourth branch of the arch. Much more rarely this condition can occur on the left if there is a mirror image arch with the subclavian anomaly.
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This page was last modified on 5/30/2003.
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