A 41-year-old female patient with thyroid carcinoma involving the right recurrent laryngeal nerve (RLN) underwent total thyroidectomy and neck dissection. The right RLN was partially removed because of the carcinomatous invasion. A resection of the posterior cricoarytenoid muscle (PCA) and a nerve graft for RLN were conducted immediately after removal of the thyroid gland. An improvement of voice was noted soon after the operation. Further improvements of voice took place 8 months later. A set of vocal function tests including the maximal phonation time, airflow rate, sound spectrogram and perceptual evaluation showed marked improvements. The voice improvement noted soon after the operation was supposed to result from median fixation of the paralyzed vocal fold by the PCA resection. The later voice improvement was presumably caused by a reduction of vocal fold atrophy by the nerve graft.
