Superior laryngeal

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:

• external laryngeal nerve

• internal laryngeal nerve

 External laryngeal nerve

• Functions : tense the vocal cords by

activating the cricothyroid muscle,
increasing pitch.
Role of cricothyroid muscle in phonation:

Contraction of cricothyroid muscle tilts the

cricoid lamina backward at the cricothyorid
joint causing lengthening, tensing and
adduction of vocal folds causing an increase
in the pitch of the voice generated.
 Internal laryngeal nerve

• Function : sensory branches to epiglottis,

base of the tongue, and the epiglottic
glands supply the mucous membrane
surrounding the entrance of the larynx,
and that lining the cavity of the larynx as
low down as the vocal folds.
 What is Neuralgia ?
• Neuralgia is an acute pathological nerve
condition characterized by an intense and
frequent, yet intermittent pain that radiates
along the length of one or more nerves.
 Axis 1
physical conditions

Neuropathic pain

Episodic pain

Paroxysmal neuralgia

Superior laryngeal neuralgia

Superior Laryngeal Neuralgia
Causes of superior laryngeal nerve
paralysis:

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

* Character of a patient with

Superior Laryngeal Nerve
Injury
 Investigation
1. Vocal capabilities

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

Miss World in 1994

THANK YOU ALL