In the diagnosis of laryngeal paralysis, one must remember the normal functions of the muscles and their nerve-supply. There are four pairs of muscles on each side which act alike and one single muscle acting on both sides at once. These are supplied by two pairs of nerves, the superior and the inferior or recurrent laryngeal nerves. Remember, the superior laryngeal nerve supplies all of the motor muscles on the outside of the larynx, consisting of just one pair, and sends no motor filaments to any other muscle. It is the sensory nerve for the whole laryngeal mucosa. All of the other laryngeal muscles are supplied by the purely motor recurrent laryngeal nerves.
The external (cricothyroid) muscle, which is supplied by the superior laryngeal nerve, regulates the tension of the cords and it is very rarely paralyzed. Paralysis of sensation is always due to involvement of the same nerve. Nearly
INGALS EF. DIAGNOSIS AND TREATMENT OF PARALYSIS OF THE VOCAL CORDS. JAMA. 1913;61(13_part_2):1221–1226. doi:10.1001/jama.1913.04350140137034
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