title: External branch of the superior laryngeal nerve: applied surgical anatomy and implications in thyroid surgery.
abstract: The external branch of the superior laryngeal nerve (EBSLN) is the only motor supply to the cricothyroid muscle and has an important role during phonation in high frequencies. Iatrogenic injury of the EBSLN, most commonly during thyroid surgery, is associated with varying levels of  alterations in phonation, which may have an impact on a patient's life, especially when his or her career depends on the full range of voice. EBSLN injury incidence after thyroid surgery ranges widely in the literature (0 to 58%). Despite this wide variation, it appears that EBSLN injury  is a not uncommon, and frequently overlooked, complication of thyroid surgery. An in-depth knowledge of the surgical anatomy of the EBSLN is therefore required from the part of the operating surgeon to protect this nerve during thyroid surgery.
authors.affiliation: 4th Department of Surgery, Athens University, Medical School, Attikon University Hospital, Athens, Greece. georgesakorafas@yahoo.com
authors.forename: George H
authors.initials: GH
authors.lastname: Sakorafas
authors.forename: Panayiotis
authors.initials: P
authors.lastname: Kokoropoulos
authors.forename: Christos
authors.initials: C
authors.lastname: Lappas
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Sampanis
authors.forename: Vassilios
authors.initials: V
authors.lastname: Smyrniotis
mesh_terms: D006801:Humans; D007049:Iatrogenic Disease; D015994:Incidence; D061224:Laryngeal Nerve Injuries / Q000209:etiology*; D007823:Laryngeal Nerves / Q000033:anatomy & histology*; D013959:Thyroid Diseases / Q000601:surgery*; D013965:Thyroidectomy / Q000009:adverse effects*