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neuralgia
Reported by
O.R.Ganeshamurthi
Introduction
• The superior laryngeal nerve is a branch
of the vagus nerve. It arises from the
middle of the ganglion nodosum and in its
course receives a branch from the
superior cervical ganglion of the
sympathetic
Introduction
• It descends, by the side of the pharynx,
behind the internal carotid artery, and
divides into two branches:
Neuropathic pain
Episodic pain
Paroxysmal neuralgia
1. Surgical
2. Neurulogical (5-10%)
3. Oesophageal tumors
4. Trauma
Causes of superior laryngeal nerve
paralysis
5. Inflammatory
6. Infectious
7. Idiopathic (20-25%)
Unilateral Superior Laryngeal
Nerve Injury
• Loss of sensation to the supraglottic larynx
can cause subtle symptoms such as
frequent throat clearing, paroxysmal
coughing, voice fatigue, vague foreign
body sensations
Bilateral Superior Laryngeal
Nerve Injury
• Fortunately, it is rare. It can result in
severe aspiration with subsequent
pneumonia.
Symptoms and Signs
• paroxysms of shock-like pain
• pain radiates into the upper thorax or up
into the jaw
• trigger zone is usually in the larynx;
attacks are precipitated by talking,
swallowing, yawning, or coughing
Symptoms and Signs
• patient might have hiccups, inspiratory
stridor, excessive salivation, or coughing
• combination of glossopharyngeal and
vagal as well as trigeminal pain has been
reported
Symptoms and Signs
About voice
1. Raspy voice
2. Voice fatigue
3. Volume deficit
4. Loss of singing volume
Diagnosis
1. History
* Typical complaints
Speaking voice
Yelling voice
Maximum phonation time
Pitch range
Investigation
2 . Laryngeal Exam
Rigid laryngoscope
Flexible laryngoscope
Neck exam
Treatment
• Unilateral Vocal Cord Paralysis:
1) Speech therapy
2) Surgical medicalization
3) Intracordal injection
4) Selective reinnervation
Treatment
• Bilateral Vocal Cord Paralysis:
1) tracheotomy
2) vocal cord lateralization
3) reinnervation
Treatment
• pharmacologic treatment
• Surgery
Name : Aishwarya Rai
place : India