The superior laryngeal nerve injury of a famous singer, Amelita Galli-Curci.

The superior laryngeal nerve (SLN) has been attributed much less clinical significance than the recurrent laryngeal nerve. It has sometimes be described as the ‘neglected’ nerve in thyroid surgery, although injury to this nerve can cause significant disability. The external branch of the superior laryngeal nerve is the only motor supply to the cricothyroid muscle, which increases the tension of the ipsilateral vocal fold during high-frequency phonation, particularly in women and voice professionals. Damage to this nerve can manifest as ipsilateral cricothyroid muscle paralysis, and clinical symptoms may include a hoarse, breathy voice, frequent throat clearing, vocal fatigue or diminished vocal frequency range, especially when rising pitch. SLN paralysis can be a significant issue for those whose careers depend largely on a full range of voice. The famous opera soprano, Amelita Galli-Curci, suffered SLN injury during thyroid surgery with distressing consequences.