“…A bilateral lesion is thus usually a very severe occurrence, such as requiring a tracheostomy. 1,2,3 The upper laryngeal nerves also innervate the vocal cords; however, they do not determine their movement but rather the degree of muscular tension, thus regulating the high tones of the voice. Their damage determines an inability to use the higher vocal tones, to sing and to use the voice for a long time.…”