Low frequency of speech, no high pitched

Introduction Symptoms of unilateral superior laryngeal nerve injury are that the frequency range of speech is reduced and cannot be treble. After the larynx is separated from the vagus nerve, the stroke in the neck is shorter, the damage is less than that of the recurrent laryngeal nerve, and it is generally unilateral, easily injured and its external branches. The laryngeal nerve is derived from the vagus nerve. The node is located close to the jugular foramen and is divided into inner and outer branches on the plane of the hyoid bone. The outer branch is often accompanied by the superior thyroid artery on the way down, usually in front of the superior thyroid artery. Secondly, the superior laryngeal nerve is located on the lower side of the inferior pharyngeal muscle. Later, it is located under the sternohyoid muscle and thyroid cartilage, and the vulvar muscle is also accepted.

Cause

1. Neck trauma (knife wounds, gunshot wounds, etc.).

2. Secondary to thyroid surgery, the superior thyroid artery is closely associated with the nerve, so when the upper thyroid artery is ligated, the nerves can be ligated together.

3. Upper laryngectomy, easy to damage the superior laryngeal nerve.

an examination

Related inspection

Otolaryngology CT examination

(1) Symptoms: The frequency range of speech is reduced, and high-pitched sounds cannot be made.

(2) Physical examination: the edge of the affected vocal cord is not neat and arched. The contraction of the circumflex muscles at the time of vocalization reverses the thyroid cartilage to the healthy side, and the healthy side of the annular cartilage is lifted upward.

(3) laryngoscopy, unilateral injury showed that the glottis was oblique, the vocal cord on the affected side was lower than the healthy side; the longitudinal tension of the bilateral vocal cords disappeared and wrinkles appeared.

Differential diagnosis

1. The sound becomes low: when a normal person presses the thyroid cartilage from the front, the sound becomes low. A phenomenon caused by a lowering of the laryngeal nerve causing the sound to become lower. Lower sound is one of the clinical manifestations of supraorbital nerve injury.

2, hoarse voice: hoarse voice, or so-called hoarseness, means that the sound is lost when it is mellow and clear. Clinically, there are varying degrees of changes in sound quality. The lightest is called "hair", that is, there is a certain degree of sound quality change when the treble is high, and the sound becomes rough. "Sand" means that the sound quality of almost all tones has changed. Moderate changes in sound quality are called . At this time, in addition to the rough and impure quality, there is still a leak, indicating that the bilateral vocal cords have significant gaps in pronunciation. Severe sound quality changes are called "dumb", that is, the glottal gap is large when the sound is emitted, the vocal cords cannot vibrate, and only the whisper can be heard.

3, vocal cord paralysis: vocal cord paralysis (vocal cord) or throat paralysis, is a clinical manifestation, not an independent disease. When the motor nerve (recurrent laryngeal nerve) of the larynx is damaged, there are three types of paralysis: vocal cord abduction, adduction, or muscle tension relaxation. Clinically, due to the longer stroke of the left recurrent laryngeal nerve, the left vocal cord paralysis is more common.

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