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The external laryngeal nerve runs with the superior thyroid artery. This nerve is a branch of the superior laryngeal nerve, which itself is a division of the vagus nerve (cranial nerve X). The external laryngeal nerve supplies motor innervation to the cricothyroid muscle, which is essential for adjusting pitch during phonation.

The proximity of the external laryngeal nerve to the superior thyroid artery is clinically significant. Surgeons need to identify and preserve this nerve during thyroid surgeries to prevent voice changes, as damage can lead to impaired vocal function due to loss of innervation to the cricothyroid muscle.

In contrast, the recurrent laryngeal nerve typically runs in the tracheoesophageal groove and is not closely associated with the superior thyroid artery, while the internal laryngeal nerve, a branch of the superior laryngeal nerve, primarily travels through the thyrohyoid membrane to supply sensory innervation. The inferior laryngeal nerve is a continuation of the recurrent laryngeal nerve and also does not travel alongside the superior thyroid artery.