Superior Laryngeal Nerve Identification and Preservation in Thyroidectomy

Injury to the external branch of the superior laryngeal nerve (EBSLN) can result in detrimental voice changes, the severity of which varies according to the voice demands of the patient. Variations in its anatomic patterns and in the rates of identification reported in the literature have discouraged thyroid surgeons from routine exploration and identification of this nerve. Inconsistent with the surgical principle of preservation of critical structures through identification, modern-day thyroidectomy surgeons still avoid the EBSLN rather than identifying and preserving it.