Superior Laryngeal Nerve Palsy After Anterior Cervical Diskectomy and Fusion: A Case Report and Cadaveric Description

• Published in: Operative neurosurgery (Hagerstown, Md.) Vol. 23; no. 2; p. e152
• Main Authors: Choy, Winward, Garcia, Joseph, Safaee, Michael M, Rubio, Roberto R, Loftus, Patricia A, Clark, Aaron J
• Format: Journal Article
• Language: English
• Published: United States 01.08.2022
• Subjects: Aged; Cadaver; Cervical Vertebrae - anatomy & histology; Cervical Vertebrae - surgery; Diskectomy - adverse effects; Humans; Laryngeal Nerves - anatomy & histology; Laryngeal Nerves - surgery; Paralysis - surgery; Spinal Fusion - adverse effects
• ISSN: 2332-4260
• DOI: 10.1227/ons.0000000000000276

Superior laryngeal nerve (SLN) injury after high cervical dissection can result in changes in vocal pitch due to cricothyroid denervation and dysphagia with aspiration risk because of decreased sensation of the supraglottic larynx. We describe a 69-year-old singer with cervical spondylotic myelopathy who underwent elective C3/4 and C4/5 anterior cervical diskectomy and fusion. Postoperatively, the patient reported changes in his voice, most noticeable with higher registers. A number of studies confirmed severe right superior laryngeal neuropathy. A cadaveric description included to highlight anatomic relationships critical in minimizing risk of SLN injury during an anterior cervical diskectomy and fusion approach. The SLN is a critical structure vulnerable to iatrogenic injury during high cervical dissections for anterior approaches to the spine. Therefore, it is critical for spine surgeons to have a firm understanding of SLN anatomy for these approaches.