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VOLUME 6 , ISSUE 2 ( July-December, 2016 ) > List of Articles


Computerized Tomographic Assessment of Vocal Cord Palsy: Otolaryngologist's Purview

Apoorva K Pandey, Tripti Maithani, Arvind Varma, Sharad Gangrade, Ankur Malhotra

Citation Information : Pandey AK, Maithani T, Varma A, Gangrade S, Malhotra A. Computerized Tomographic Assessment of Vocal Cord Palsy: Otolaryngologist's Purview. Int J Phonosurg Laryngol 2016; 6 (2):57-63.

DOI: 10.5005/jp-journals-10023-1123

License: CC BY 3.0

Published Online: 01-06-2012

Copyright Statement:  Copyright © 2017; The Author(s).


Aims and objectives

Vocal cord palsy (VCP) can be definitely depicted on computed tomograpy (CT) scan by identifying key points at the level of true vocal cords and aryepiglottic folds. There are various VCP mimics and imaging shortcomings, and these can usually be circumvented by thoughtfully assessing the scan plan and level, and a diligent search for additional characteristics.

Materials and methods

This retrospective study consisted of 10 cases of unilateral VCP, who all had been clinically diagnosed of VCP and further evaluated by CT. Pre- and postcontrast enhanced axial CT from skull base to aorto-pulmonary window were done and multiplanar three-dimensional reconstruction of images in coronal and sagittal planes along with volume-rendered imaging was done.


Most consistent findings in VCP were thickening of ipsilateral aryepiglottic fold and medialization of ipsilateral aryepiglottic fold (100%), followed by dilation of ipsilateral pyriform sinus (90%) and dilatation of ipsilateral laryngeal ventricle (80%). Etiologic causes were ascertained in three cases: Thyroid malignancy, tuberculosis, and pyriform sinus malignancy. The last etiology was probably a VCP mimic.


Radiologic evaluation is inarguably useful for determining the etiology of VCP, particularly for lesions within neck and thoracic cavity. Most crucial objective in assessing a case of VCP is to exclude the presence of a life-threatening primary lesion as the cause of VCP.

How to cite this article

Pandey AK, Gangrade S, Malhotra A, Varma A, Maithani T. Computerized Tomographic Assessment of Vocal Cord Palsy: Otolaryngologist's Purview. Int J Phonosurg Laryngol 2016;6(2):57-63.

  1. Clinical evaluation of vocal fold paralysis. Otolaryngol Clin North Am 2004 Feb;37(1):45-58.
  2. Using CT to localize side and level of vocal cord paralysis. AJR Am J Roentgenol 2003 Apr;180(4):1165-1170.
  3. Relationship between vocal cord paralysis and benign thyroid disease. Head Neck 1995 Jan-Feb;17(1):24-30.
  4. Unilateral vocal cord paralysis: a review of CT findings, mediastinal causes, and the course of the recurrent laryngeal nerves. Radiographics 2012 May-Jun;32(3):721-740.
  5. Laryngography: cine laryngography. Baltimore (MD): Williams & Wilkins; 1970. p. 62-75.
  6. The larynx. In: Som PM, Curtin HD, editors. Head and neck imaging. 4th ed. St. Louis (MO): Mosby; 2003. p. 1601-1603.
  7. Surgical management of the paralyzed larynx. In: Bailey BJ, Biller HF, editors. Surgery of the larynx. Philadelphia (PA): Saunders; 1985. p. 117-134.
  8. Causes of recurrent laryngeal paralysis. Auris Nasus Larynx 2002 Jan;29(1):41-45.
  9. Causes of recurrent laryngeal nerve paralysis. Arch Otolaryngol 1976 May;102(5):259-261.
  10. Imaging evaluation of vocal cord paralysis. Radiol Bras 2009;42(5):321-326.
  11. Vocal fold immobility: a longitudinal analysis of etiology over 20 years. Laryngoscope 2007 Oct;117(10):1864-1870.
  12. CT evaluation of vocal cord paralysis due to thoracic diseases: a 10-year retrospective study. Yonsei Med J 2011;52(5):831-837.
  13. Extralaryngeal causes of vocal cord paralysis: CT evaluation. AJR Am J Roentgenol 1983 Sep;141(3):527-531.
  14. Statistical analysis of malignant tumours detected as the cause of vocal cord paralysis. ORL J Otorhinolaryngol Relat Spec 1994 May-Jun;56(3):161-165.
  15. Etiology of bilateral abductor vocal cord paralysis: a review of 389 cases. Ann Otol Rhinol Laryngol 1976 Jul-Aug;85(4 Pt 1):428-436.
  16. Radiology findings in adult patients with vocal fold paralysis. Clin Radiol 2006 Oct;61(10):863-867.
  17. Vocal cord paralysis: anatomy, imaging and pathology. Insights Imaging 2014 Dec;5(6):743-751.
  18. Rcurrent laryngeal nerve paralysis: a laryngographic and computed tomographic study. Radiology 1983 Jul;148(1):149-155.
  19. Neurologic disorders. In: Tucker HM, editor. The Larynx. 2nd ed. New York (NY): Thieme; 1993. p. 247-249.
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