A 56-year-old woman has just undergone a complete thyroidectomy. After she recovers from the anesthesia a hoarseness of her voice is noted that persists for 3 weeks. Subsequent examination shows a permanently adducted vocal fold on the right side. Surgical trauma to the innervation of which of the following muscles is most likely to be responsible for the position of the right vocal fold?
The recurrent laryngeal nerve is often at risk of being damaged during a thyroidectomy. Patients who have a transected or damaged recurrent laryngeal will often present with a characteristic hoarseness following surgery. The posterior cricoarytenoid is supplied by the recurrent laryngeal and would thus be impaired following damage to the nerve. The posterior cricoarytenoid is the only muscle responsible for abduction of the vocal cords, and paralysis of this muscle would result in a permanently adducted position of the involved vocal cord. The other muscles listed are all adductors of the vocal cords, and paralysis of these would not lead to closure of the airway.
Aryepiglottic
Posterior cricoarytenoid
Thyroarytenoid
Transverse arytenoids
Head & Neck