Vocal cord paralysis: anatomy, imaging and pathology

Area of Science:

• Radiology
• Neuroanatomy
• Pathology

Background:

• Vocal cord paralysis (VCP) arises from disruptions in vagal or recurrent laryngeal nerve function.
• VCP can be an initial indicator of significant and severe systemic or localized pathology.
• Accurate diagnosis requires radiologists to identify imaging features of VCP and understand relevant neuroanatomy.

Purpose of the Study:

• To review the anatomy of the vagal and recurrent laryngeal nerves.
• To detail the imaging evaluation of these nerves and potential sites of pathology.
• To discuss imaging characteristics and mimics of VCP with illustrative clinical cases.

Main Methods:

• Anatomical review of the vagal and recurrent laryngeal nerves.
• Discussion of imaging techniques for evaluating these nerves.
• Presentation of clinical cases demonstrating causes and imaging findings of VCP.

Main Results:

• Pathology along the vagal nerves and recurrent laryngeal nerves can lead to VCP.
• Understanding nerve pathways is crucial for localizing lesions.
• Imaging characteristics and potential mimics of VCP are detailed.

Conclusions:

• Vocal cord paralysis may present as the initial sign of severe disease.
• Radiologists must be proficient in recognizing the imaging hallmarks and differential diagnoses of VCP.
• Lesions affecting the vagal and recurrent laryngeal nerves are primary causes of VCP.