Preoperative functional assessment of the recurrent laryngeal nerve in patients with cervical vertebra fracture: case report

Injury to the recurrent laryngeal nerve may occur during surgical intervention to the anterior part of the neck. However, some disorders can lead to damage to the recurrent laryngeal nerve before surgery. We report 2 cases of lower cervical vertebra fracture, leading to 1-sided injury of the recurrent laryngeal nerve. One man and 1 woman with neck injuries were admitted to our hospital. The man had a C7-T1 dislocation fracture, and the woman had a C6-C7 dislocation fracture. Both patients had similar fractures and similar clinical presentations. The distinctive feature of these cases is that both patients had dysphonia after the initial injuries but before surgery. Both patients were treated surgically, and anterior and posterior cervical stabilization was performed. During surgical intervention to the anterior part of the neck for cervical fixation, the injured side (where the vocal cords did not move during an indirect laryngoscopy) was preferred. Patients with a cervical vertebra fracture with dysphonia and hoarseness should be examined for vocal cord dysfunction. Surgical intervention should be performed on the side of the injured recurrent laryngeal nerve.