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Old 08-05-2012
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Default Which nerve impaired on thyroid gland operation

A 30-year-old woman comes to the clinic because of a 10-month history of swelling located midline in the anterior part of the neck that has become larger and harder during the past 6 months. Physical examination shows a diffusely enlarged thyroid gland. During surgery, the nerve that pierces the thyrohyoid membrane is cut. Which of the following complications is most likely to occur as a result of this injury?

a) Hoarseness
b) Impaired movement of the hyoid bone
c) Impaired movement of the tongue
d) Recurrent Aspiration
e) Spasm of the muscles of the larynx
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Old 08-05-2012
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2 nerves have a chances of getting injured.
Recurrent laryngeal nerve: passes posterior to thyroid gland , causes hoarseness
Superficial laryngeal nerve: passes somewhere along thyroid gland ( :-) ), this cause problem producing high pitch voice. Thank god those Opera singer will not able to shout . If I would be there surgeon. Hehehe
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According to option I would say A. But if there's some twisting question which I can't see then. God knows.


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Old 08-05-2012
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Quote:
Originally Posted by Casandra View Post
a) Hoarseness
b) Impaired movement of the hyoid bone
c) Impaired movement of the tongue
d) Recurrent Aspiration
e) Spasm of the muscles of the larynx

Recurrent laryngeal nerve
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Old 08-05-2012
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i think its A too
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Old 08-06-2012
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Default correct answer

The answer is d) Recurrent Aspiration

The internal branch of the superior laryngeal nerve of the vagus nerve (CN X) travels through the thyrohyoid membrane. It supplies the sensation of the laryngeal mucosa up to the level of the vocal cords which detect presence of foreign bodies. This area is responsible for initiating the laryngeal cough reflex when foreign bodies are detected in the laryngeal area, which protects humans against aspiration. Injury to this nerve could result in recurrent aspiration that could lead to pneumonia and other respiratory illness.

As for A) - The external branch of the superior laryngeal nerve of the vagus does not pierce the thyrohyoid membrane; however, it lies deep to the superior thyroid artery, making it susceptible to injuries during thyroid surgeries. It pierces the inferior constrictor muscles and supplies the motor fibers of the cricothryroid muscles. The cricothyroid muscle is responsible for producing tension in the vocal cords, so injury to the nerve that causes weakness or paralysis of the cricothyroid muscle could result in subtle to obvious hoarseness.
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Thanks , didn't read the question just topic .
Whenever seems easy read twice.
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