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Topographic anatomy of the external branch of the superior laryngeal nerve

Its importance in head and neck surgery

Published online by Cambridge University Press:  29 June 2007

V. Kambič*
Affiliation:
Ljubljana, Yugoslavia
M. Žargi
Affiliation:
Ljubljana, Yugoslavia
Zora Radšel
Affiliation:
Ljubljana, Yugoslavia
*
Department of Otolaryngology, Zaloška 2, 61105 Ljubljana, Yugoslavia.

Abstract

The authors have studied the anatomy of the external branch of the superior laryngeal nerve in its entirety on 40 fresh cadavers, and they have drawn the following conclusions: the nerve ramifies from the vagus immediately below the nodose ganglion or in the ganglion itself. The nerve splits into two branches approximately 1.5 cm below the ganglion nodosum. In four cases, both branches originated from the vagus itself. In one case, anastomosis of the external branch of the superior laryngeal nerve with the recurrent nerve was found. The external branch of the superior laryngeal nerve is not usually severed at supraglottic laryngectomy but the nerve is at risk during neck dissections, resection of Zenker's diverticula and thyroidectomy. An accurate knowledge of its course should reduce the incidence of injury to the branches of the superior laryngeal nerve during surgery.

Type
Research Article
Copyright
Copyright © JLO (1984) Limited 1984

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References

Abelson, T. I. and Tucker, H. M. (1981). Laryngeal findings in superior laryngeal nerve paralysis: A controversy. Otolaryngology and Head and Neck Surgery, 89: 463470.CrossRefGoogle ScholarPubMed
Adour, K. K., Schneider, G. D. and Hilsinger, R. L. Jr. (1980). Acute superior laryngeal nerve palsy: Analysis of 78 cases. Otolaryngology and Head and Neck Surgery, 88: 418424.CrossRefGoogle ScholarPubMed
Arnold, G. E. (1961). Physiology and pathology of the cricothyroid muscle. Laryngoscope, 71: 685753.CrossRefGoogle ScholarPubMed
Arnold, G. E. (1962). Vocal rehabilitation of paralytic dysphonia. Archives of Otolaryngology, 75: 549570.CrossRefGoogle ScholarPubMed
Bocca, E., Pignataro, O. and Mosciaro, O. (1968). Supraglottic surgery of the larynx. Annals of Otology, Rhinology and Laryngology, 77: 10051026.CrossRefGoogle ScholarPubMed
Clader, D. N., Luter, P. W. and Daniels, B. T. (1957). A photographic study of the superior and inferior laryn geal nerves and the superior and inferior thyroid arteries. The American Surgeon, 23: 609618.Google Scholar
Crumley, R. L. (1983). Phrenic nerve graft for bilateral vocal cord paralysis. Laryngoscope, 93: 425428.CrossRefGoogle ScholarPubMed
Dedo, H. H. (1970). The paralyzed larnyx: An electromyographic study in dogs and humans. Laryngoscope, 80: 14551517.CrossRefGoogle Scholar
Dil worth, T. F. M. (19211922). The nerves of the human larynx. Journal of Anatomy, 56: 4852.Google Scholar
Durham, C. F. and Harrison, T. S. (1964). The surgical anatomy of the superior laryngeal nerve. Surgery, Gynecology and Obstetrics, 118: 3844.Google ScholarPubMed
Flores, T. C., Wood, B. G., Koegel, L. Jr, Levine, H. L. and Tucker, H. M. (1982). Factors in successful deglutition following supraglottic laryngeal surgery. Annals of Otology, Rhinologv and Laryngology, 91: 579583.CrossRefGoogle ScholarPubMed
Hill, J. H. and Olson, N. R. (1979). The surgical anatomy of the spinal accessory nerve and the internal branch of the superior laryngeal nerve. Laryngoscope, 89: 19351942.CrossRefGoogle ScholarPubMed
King, B. T. and Gregg, R. L. (1948). An anatomical reason for the various behaviors of paralyzed vocal cords. Annals of Otology, Rhinology and Laryngology, 57: 925944.CrossRefGoogle ScholarPubMed
Lemere, F. (1932). Innervation of the larynx–II. ramus anastomoticus and ganglion cells of the superior laryngeal nerve. The Anatomical Record, 54: 389407.CrossRefGoogle Scholar
Lemere, F. (1933). Innervation of the larynx–III. experimental paralysis of the laryngeal nerve. Archives of Otolaryngology, 18: 413424.CrossRefGoogle Scholar
Loré, J. M., Kim, D. J. and Elias, S. (1977). Preservation of the laryngeal nerves during total thyroid lobectomy. Annals of Otology, Rhinology and Laryngology, 86: 777788.CrossRefGoogle ScholarPubMed
Mayet, A. (1956). Zur Innervation des M. cricothyreoideus. Anatomischer Anzeiger, 103: 340343.Google Scholar
Mayet, A. and Mundnich, K. (1958). Beitrag zur Anatomie und zur Funktion des M.cricothyreoideus und der Cricothyreoidgelenke. Acta Anatomica, 33: 273288.CrossRefGoogle Scholar
Moosman, D. A. and De Weese, M. S. (1968). The external laryngeal nerve as related to thyroidectomy. Surgery, Gynecology and Obstetrics, 127: 10111016.Google ScholarPubMed
Newman, A. N. and Becker, S. P. (1981). Superior laryngeal nerve paralysis and benign thyroid disease. Archives of Otolaryngology, 107: 117119.CrossRefGoogle ScholarPubMed
Ribet, R. M. de (1952). Les nerfs craniens G. Doin and Cie, Paris, pp. 457471.Google Scholar
Rice, D. H., Owens, O., Burstein, F. and Verity, A. (1983). The nerve-muscle pedicle. Archives of Otolaryngology, 109: 233234.CrossRefGoogle ScholarPubMed
Tschiassny, K. (1944). Studies concerning the action of the musculus cricothyreoideus. Laryngoscope, 54: 589604.CrossRefGoogle Scholar
Tschiassny, K. (1957). Therapeutically induced paralysis of the cricothyroid muscle or its removal in paralytic laryngeal stenosis. A. M. A. Archives of Otolaryngology, 65: 133142.CrossRefGoogle ScholarPubMed
Tucker, H. M. (1976). Human laryngeal reinnervation. Laryngoscope, 86: 769779.CrossRefGoogle ScholarPubMed
Tucker, H. M. (1978). Human laryngeal reinnervation: Long-term experience with nerve muscle pedicle technique. Laryngoscope, 88: 598604.CrossRefGoogle ScholarPubMed
Tucker, H. M. (1981). Surgery for phonatory disorders, Churchill Livingstone, New York, Edinburgh, London and Melbourne, pp. 13.Google Scholar
Ward, P. H., Berci, G. and Calcaterra, T. C. (1977). Superior laryngeal nerve paralysis: An often overlooked entity. Transactions of American Academy of Ophtalmology and Otolaryngology, 84: 7888.Google ScholarPubMed