External branch of the superior laryngeal nerve

Voice and swallowing complaints are common after thyroidectomy, but their etiology is not completely understood. Manipulation of the endolaryngeal soft tissues, pharyngeal constrictor muscles, and recurrent laryngeal nerves may all result in symptoms. In addition, the external branch of the superior laryngeal nerve and cricothyroid muscle may play a role in postoperative dysphonia. We review the literature related to the scope of voice complaints after thyroidectomy. We also discuss several studies describing the surgical anatomy of the external branch of the superior laryngeal nerve as it relates to thyroidectomy. Our surgical technique, which includes routine visualization of the external branch of the superior laryngeal nerve, is then described.