A 38-year-old saleswoman developed left neck and shoulder pain. Evaluation revealed a cervical disc herniation with surgery recommended. In the recovery room following surgery, she noticed a marked change in her voice, which now had a breathy quality. She was reassured that this was only a temporary effect of the intubation. However, over the next 2 months she continued to have severe breathiness of her voice making it difficult to use her voice at work. After 2 months, she was referred to an otolaryngologist. His observations included a soft, breathy voice suggesting that an air leak was present in her larynx.
Based on the case history, where is the most likely site of lesion?
A.cranial nerve V, superior laryngeal branch
B. bilateral upper motor lesions in region of internal capsule outflow from motor stripes
C. cranial nerve X, inferior (recurrent) laryngeal branch
D. left cerebellar hemisphere
E. precentral gyrus, right hemishere