{"id":905,"date":"2022-07-20T18:50:00","date_gmt":"2022-07-20T18:50:00","guid":{"rendered":"https:\/\/www.osmosis.org\/blog\/?p=905"},"modified":"2026-02-20T16:54:53","modified_gmt":"2026-02-21T00:54:53","slug":"usmle-step-1-question-of-the-day-thyroid-surgery-complications","status":"publish","type":"post","link":"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-thyroid-surgery-complications","title":{"rendered":"USMLE\u00ae Step 1 Question of the Day: Thyroid Surgery Complications"},"content":{"rendered":"<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_80 ez-toc-wrap-center counter-hierarchy ez-toc-counter ez-toc-custom ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">In This Article<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-thyroid-surgery-complications\/#The_correct_answer_to_todays_USMLE%C2%AE_Step_1_Question_is%E2%80%A6\" >The correct answer to today&#8217;s USMLE\u00ae Step 1 Question is&#8230;<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-thyroid-surgery-complications\/#Incorrect_Answer_Explanations\" >Incorrect Answer Explanations<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-thyroid-surgery-complications\/#Main_Explanation\" >Main Explanation<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-thyroid-surgery-complications\/#Major_Takeaway\" >Major Takeaway<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-thyroid-surgery-complications\/#References\" >References<\/a><\/li><\/ul><\/nav><\/div>\n\n<p class=\"wp-block-paragraph\"><em>This week, we&#8217;re sharing another <strong>USMLE\u00ae Step 1<\/strong>-style practice question to test your knowledge of <strong>medical topics<\/strong>.&nbsp;Today&#8217;s case focuses on a 45-year-old woman experiencing <strong>voice changes<\/strong> after a <strong>thyroidectomy<\/strong>. Can you figure it out?<\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A 45-year-old woman is evaluated for <strong>voice changes <\/strong>after <strong>thyroid surgery.<\/strong> The patient was diagnosed with&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Thyroid_cancer\" target=\"_blank\" rel=\"noreferrer noopener\"><strong>papillary thyroid cancer<\/strong><\/a>&nbsp;and subsequently underwent <strong>thyroidectomy<\/strong>. Immediately after the surgery, she noticed some mild voice changes, but the doctor informed her that this is usually <strong>transient <\/strong>due to local <strong>edema <\/strong>and will likely <strong>self-resolve.<\/strong> Currently, the patient describes only mild <strong>voice <\/strong>and <strong>pitch changes <\/strong>but denies any <strong>dysphagia<\/strong>. On physical examination, sensation of the mucosa above the <strong>glottis <\/strong>is intact. After evaluation, the doctor suspects an isolated unilateral <strong>paralysis <\/strong>of the <strong>cricothyroid muscle<\/strong>.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Which of the following <strong>nerves <\/strong>demonstrated in the picture below was <em>most likely injured<\/em> during the surgery?<\/p>\n\n\n\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"605\" height=\"437\" src=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/thyroid-surgery-and-laryngeal-nerves.png\" alt=\"Osmosis illustration of thyroid surgery and laryngeal nerves anterior.\" class=\"wp-image-906\" srcset=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/thyroid-surgery-and-laryngeal-nerves.png 605w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/thyroid-surgery-and-laryngeal-nerves.png?resize=300,217 300w\" sizes=\"auto, (max-width: 605px) 100vw, 605px\" \/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>A. <\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>B. <\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>C. <\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>D. <\/strong><\/p>\n\n\n\n<p class=\"has-text-align-center wp-block-paragraph\"><em>Scroll down to find the answer!<\/em><\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-rich is-provider-embed-handler wp-block-embed-embed-handler wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" title=\"Everybody loves Osmosis.org\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/kizbJZ9cdLg?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n\n\n<p class=\"has-text-align-center wp-block-paragraph\"><em><a href=\"https:\/\/www.osmosis.org\/plans\" target=\"_blank\" rel=\"noreferrer noopener\"><u><em><strong>\u2192 Reinforce your understanding with more self-assessment items with Osmosis<\/strong><\/em><\/u><\/a><\/em><\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"The_correct_answer_to_todays_USMLE%C2%AE_Step_1_Question_is%E2%80%A6\"><\/span>The correct answer to today&#8217;s USMLE\u00ae Step 1 Question is&#8230;<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>C.<\/strong> <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Before we get to the Main Explanation, let&#8217;s look at the incorrect answer explanations. Skip to the bottom if you want to see the correct answer right away!<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Incorrect_Answer_Explanations\"><\/span>Incorrect Answer Explanations<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>A.<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:<\/strong>&nbsp;A is the&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Anatomy_of_the_larynx_and_trachea\" target=\"_blank\" rel=\"noreferrer noopener\"><strong>superior laryngeal nerve<\/strong><\/a>&nbsp;which splits into the <strong>internal <\/strong>and <strong>external laryngeal nerves.<\/strong> Injury in this location will result in both unilateral paralysis of the&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Anatomy_of_the_larynx_and_trachea\" target=\"_blank\" rel=\"noreferrer noopener\">cricothyroid muscle<\/a>&nbsp;(external laryngeal nerve) and <strong>sensation deficit<\/strong> (internal laryngeal nerve) above the vocal cord. The patient has intact sensation.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>B.<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:&nbsp;<\/strong>B is the&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Anatomy_of_the_larynx_and_trachea\" target=\"_blank\" rel=\"noreferrer noopener\"><strong>internal laryngeal nerve<\/strong><\/a>, a branch of the superior laryngeal nerve. Injury in that location will result in a <strong>sensory deficit<\/strong> above the vocal cord. The patient has intact sensation.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>D.<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:&nbsp;<\/strong>D is the <strong>recurrent laryngeal nerve<\/strong>, a branch of the&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Anatomy_of_the_vagus_nerve_(CN_X)\" target=\"_blank\" rel=\"noreferrer noopener\"><strong>vagus nerve<\/strong><\/a>. Injury in this location will result in severe <strong>hoarseness <\/strong>and <strong>dysphagia <\/strong>due to paralysis of the <strong>posterior cricoarytenoid, lateral cricoarytenoid, oblique arytenoid, transverse arytenoid, <\/strong>and <strong>thyroarytenoid muscles<\/strong>. This patient has only mild symptoms, which favors another diagnosis.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><a href=\"https:\/\/www.osmosis.org\/plans\/md\" target=\"_blank\" rel=\"noreferrer noopener\"><img loading=\"lazy\" decoding=\"async\" width=\"700\" height=\"250\" src=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/08\/health-medicine-try-it-now.png?w=700\" alt=\"The most powerful platform for learning medicine and the health sciences Try it now button.\" class=\"wp-image-363\" srcset=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/08\/health-medicine-try-it-now.png 700w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/08\/health-medicine-try-it-now.png?resize=300,107 300w\" sizes=\"auto, (max-width: 700px) 100vw, 700px\" \/><\/a><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Main_Explanation\"><\/span>Main Explanation<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">This patient has&nbsp;<strong>mild voice changes<\/strong>&nbsp;without dysphagia&nbsp;<strong>following&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Anatomy_clinical_correlates:_Vessels,_nerves_and_lymphatics_of_the_neck\" target=\"_blank\" rel=\"noreferrer noopener\">thyroidectomy<\/a><\/strong>, which raises concern for <strong>iatrogenic nerve injury<\/strong> caused by surgery. Complications during thyroid surgery are common and may include <strong>hematoma<\/strong>\/wound seroma,&nbsp;<strong><a href=\"https:\/\/www.osmosis.org\/learn\/Hypocalcemia\" target=\"_blank\" rel=\"noreferrer noopener\">hypocalcemia<\/a>&nbsp;<\/strong>due to&nbsp;<strong><a href=\"https:\/\/www.osmosis.org\/learn\/Hypoparathyroidism\" target=\"_blank\" rel=\"noreferrer noopener\">hypoparathyroidism<\/a>,<\/strong> <strong>hoarseness, voice changes, vocal cord paralysis,&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Horner_syndrome\" target=\"_blank\" rel=\"noreferrer noopener\">Horner syndrome<\/a>, chyle fistula, tracheal and esophageal injuries, <\/strong>and <strong>dysphagia.<\/strong><\/p>\n\n\n\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"605\" height=\"437\" src=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/thyroid-surgery-and-laryngeal-nerves-2.png\" alt=\"Thyroid surgery and Laryngeal Nerves Anterior\nLeft, top to bottom:\nSuperior Thyroid A\nRight Vagus Nerve\nInferior Thyroid A.\nRight Recurrent Laryngeal Nerve\nRight, top to bottom:\nSuperior Laryngeal Nerve\nInternal Laryngeal Nerve\nExternal Laryngeal Nerve\nLeft Vagus Nerve\nLeft Recurrent Laryngeal Nerve\" class=\"wp-image-907\" srcset=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/thyroid-surgery-and-laryngeal-nerves-2.png 605w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/thyroid-surgery-and-laryngeal-nerves-2.png?resize=300,217 300w\" sizes=\"auto, (max-width: 605px) 100vw, 605px\" \/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">The <strong>laryngeal nerves<\/strong> are at risk for injury during thyroid surgery. The&nbsp;<strong>vagus nerve<\/strong>&nbsp;gives rise to a branch named the&nbsp;<strong><a href=\"https:\/\/www.osmosis.org\/learn\/Anatomy_of_the_larynx_and_trachea\" target=\"_blank\" rel=\"noreferrer noopener\">superior laryngeal nerve<\/a><\/strong>&nbsp;(SLN) about 4 cm above the carotid bifurcation. The SLN then divides into the&nbsp;<strong><a href=\"https:\/\/www.osmosis.org\/learn\/Anatomy_of_the_larynx_and_trachea\" target=\"_blank\" rel=\"noreferrer noopener\">internal laryngeal nerve<\/a><\/strong>&nbsp;and<strong>&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Anatomy_of_the_larynx_and_trachea\" target=\"_blank\" rel=\"noreferrer noopener\">external laryngeal nerve<\/a><\/strong>. The internal branch supplies&nbsp;<strong>sensory innervation<\/strong>&nbsp;to the&nbsp;<strong>supraglottic region<\/strong>, whereas the <strong>external branch<\/strong> carries motor innervation to the&nbsp;<strong><a href=\"https:\/\/www.osmosis.org\/learn\/Anatomy_of_the_larynx_and_trachea\" target=\"_blank\" rel=\"noreferrer noopener\">cricothyroid muscle<\/a><\/strong>. Damage to the external branch may occur during ligation of the <strong>superior thyroid artery.<\/strong> External laryngeal nerve injury <strong>impairs the cricothyroid muscle<\/strong>, which is responsible for abduction and opening of the rima glottis by rotating the arytenoid cartilage laterally. Patients may experience vocal fatigue and subtle voice changes.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/osmosis.org\/embed\/Anatomy_of_the_larynx_and_trachea\"><strong>\u2192 Learn more about the anatomy of the larynx and the trachea with Osmosis!<\/strong><\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">After branching into the SLN, the vagus nerves continue caudally and give rise to the&nbsp;<strong><a href=\"https:\/\/www.osmosis.org\/learn\/Anatomy_of_the_vagus_nerve_(CN_X)\" target=\"_blank\" rel=\"noreferrer noopener\">recurrent laryngeal nerve<\/a>&nbsp;(RLN)<\/strong>. The RLN <strong>innervates&nbsp;all intrinsic muscles<\/strong>&nbsp;of the larynx&nbsp;<strong>except&nbsp;<\/strong>the cricothyroid as well as sensation <strong>below the vocal cord.<\/strong> These muscles function to adduct the vocal cords and close the rima glottis. RLN injury can occur during ligation of the inferior thyroid artery. Since the RLN innervates the majority of the intrinsic laryngeal muscles, its damage results in&nbsp;<strong>more severe<\/strong>&nbsp;symptoms. These include <strong>respiratory obstruction, hoarseness, inability to speak, <\/strong>and <strong>loss of sensation below the vocal cord.<\/strong><\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Major_Takeaway\"><\/span>Major Takeaway<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>The&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Anatomy_of_the_larynx_and_trachea\" target=\"_blank\" rel=\"noreferrer noopener\">superior laryngeal nerve<\/a>&nbsp;and its branches can be injured during ligation of the superior thyroid artery.<\/strong><\/li>\n\n\n\n<li><strong>This results in loss of sensation to the&nbsp;supraglottic region&nbsp;(internal branch) and paralysis of the&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Anatomy_of_the_larynx_and_trachea\" target=\"_blank\" rel=\"noreferrer noopener\">cricothyroid muscle<\/a>&nbsp;(external branch).<\/strong><\/li>\n\n\n\n<li><strong>This will result in&nbsp;mild&nbsp;voice changes compared to recurrent laryngeal nerve injury, which innervates the majority of the intrinsic laryngeal muscles.<\/strong><\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"References\"><\/span>References<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Orestes, M. and Chhetri, D. (2020). Superior laryngeal nerve injury. [online] Available at: https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4316678\/#!po=70.8333 [Accessed 12 Jan. 2020]. doi:&nbsp;<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/25136863\/\" target=\"_blank\" rel=\"noreferrer noopener\">10.1097\/MOO.0000000000000097<\/a><\/li>\n\n\n\n<li>Rosato L, Avenia N, Bernante P, et al.&nbsp;<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/14961204\/\" target=\"_blank\" rel=\"noreferrer noopener\">Complications of thyroid surgery: analysis of a multicentric study on 14,934 patients operated on in Italy over 5 years<\/a>. World J Surg 2004; 28:271.<\/li>\n\n\n\n<li>Dralle H, Sekulla C, Lorenz K, et al.&nbsp;<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/18305996\/\" target=\"_blank\" rel=\"noreferrer noopener\">Intraoperative monitoring of the recurrent laryngeal nerve in thyroid surgery<\/a>. World J Surg 2008; 32:1358.<em><br><\/em><a href=\"https:\/\/www.osmosis.org\/ultimate-guide\/usmle-step-1\" target=\"_blank\" rel=\"noreferrer noopener\"><\/a><\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-image size-large\"><a href=\"https:\/\/www.osmosis.org\/ultimate-guide\/usmle-step-1\"><img loading=\"lazy\" decoding=\"async\" width=\"700\" height=\"250\" src=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/the-ultimate-guide-usmle-step-1-banner.png?w=700\" alt=\"\" class=\"wp-image-760\" srcset=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/the-ultimate-guide-usmle-step-1-banner.png 700w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/the-ultimate-guide-usmle-step-1-banner.png?resize=300,107 300w\" sizes=\"auto, (max-width: 700px) 100vw, 700px\" \/><\/a><figcaption class=\"wp-element-caption\"><em><sub>The United States Medical Licensing Examination (USMLE\u00ae) is a joint program of the Federation of State Medical Boards (FSMB\u00ae) and National Board of Medical Examiners (NBME\u00ae). Osmosis is not affiliated with NBME nor FSMB.&nbsp;<\/sub><\/em><\/figcaption><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\"><em>Want more <strong>USMLE\u00ae Step 1 practice questions<\/strong>? Try <strong>Osmosis from Elsevier <\/strong>today! Access your&nbsp;<em><a href=\"https:\/\/www.osmosis.org\/plans\" target=\"_blank\" rel=\"noreferrer noopener\"><strong>f<\/strong><\/a><a href=\"https:\/\/www.osmosis.org\/login?type=create\" target=\"_blank\" rel=\"noreferrer noopener\"><strong>ree trial<\/strong><\/a><\/em>&nbsp;and find out why millions of current and future <strong>clinicians and caregivers love learning by Osmosis<\/strong>.<\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Enhance your USMLE\u00ae Step 1 exam preparation with a clinical case. A patient develops voice changes after thyroid surgery. Learn which nerve injury is most likely and how it presents clinically.<\/p>\n","protected":false},"author":202,"featured_media":909,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_post_was_ever_published":false},"categories":[27,20,16,1369,44],"tags":[150,601,1749,838,440,1750,84,602,245,279,1747,1748,600,1091,185,664,1746,603],"class_list":["post-905","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-medicine","category-exam-prep","category-do","category-step-1-questions","category-step-1","tag-clinical-practice","tag-complications","tag-cricothyroid-muscle","tag-dysphagia","tag-emergency-medicine","tag-laryngeal-anatomy","tag-medical-education","tag-nerve-injury","tag-nursing-education","tag-patient-assessment","tag-recurrent-laryngeal-nerve","tag-superior-laryngeal-nerve","tag-thyroid-surgery","tag-thyroidectomy","tag-usmle","tag-usmle-step-1","tag-voice-changes","tag-voice-disorders"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v23.6 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>USMLE\u00ae Step 1 Question of the Day: Thyroid Surgery Complications - Osmosis Blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-thyroid-surgery-complications\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"USMLE\u00ae Step 1 Question of the Day: Thyroid Surgery Complications - Osmosis Blog\" \/>\n<meta property=\"og:description\" content=\"Enhance your USMLE\u00ae Step 1 exam preparation with a clinical case. A patient develops voice changes after thyroid surgery. 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