If related to surgery, risk goes up with repeat operation (scarring), failure to identify the nerve at time of surgery, less experienced operators, more extensive surgery
Malignancy of head/neck, mediastinum
Symptoms
Typically causes a breathy voice (unilateral nerve dysfunction), hoarseness, vocal fatigue
SOB, DOE, respiratory distress with bilateral involvement
Sometimes dysphagia, coughing
If neurological disorder (e.g. ALS), then will have additional symptoms
Physical Exam Findings
Soft or breathy voice
Respiratory distress, stridor if bilateral involvement
Other neurological findings if there's an underlying disorder