We experienced anesthesia for three cases of unilateral recurrent nerve palsy scheduled for thyroplasty type I requiring voice monitoring. The patients were sedated with dexmedetomidine and locally anesthetized. Dexmedetomidine provided sedation of high quality with natural sleep, good response to asking for phonation and very few respiratory depressions. We conclude that dexmedetomidine is an excellent sedative as a drug used for voice monitoring surgery.