Question: A 42 year old woman who participates heavily in her church singing group undergoes hemithyroidectomy for a pathologically T1 papillary thyroid carcinoma. On postoperative day 1 she was swallowing normally and endorsed no voice complaints. Laryngoscopic examination demonstrated symmetric vocal fold mobility. She returns in follow up 6 weeks later and has noticed a mild change in her ability to hit high pitched notes. Injury to which nerve may be responsible for her symptoms? [Answer will be posted with next week's new question]

Answer to last week's question, "Face the Facts" (August 14, 2017)

Close observation to rule out local anesthetic related neurapraxia. If it fails to resolve after several hours, exploration may be warranted after consultation with a colleague.