Unilateral vocal cord paralysis: A comprehensive guide for general radiologists

Area of Science:

• Neurology
• Radiology
• Otolaryngology

Background:

• Unilateral vocal cord paralysis (UVCP) results from neurological dysfunction affecting one side of the larynx.
• The recurrent laryngeal nerve (RLN), a branch of the vagus nerve (VN), innervates laryngeal muscles; damage to the VN or RLN causes UVCP.
• Distinguishing UVCP from mechanical vocal cord issues is critical.

Purpose of the Study:

• To offer a structured radiological guide for evaluating UVCP.
• To detail clinical assessment, imaging protocols, anatomy, and nerve pathways relevant to UVCP.

Main Methods:

• Comprehensive literature review of current imaging standards.
• Synthesis of a diagnostic approach for UVCP evaluation from brainstem to mediastinum.

Main Results:

• Causes of UVCP can be inflammatory, vascular, or neoplastic, occurring anywhere from the brainstem to the mediastinum.
• A structured anatomical approach allows systematic evaluation of the nerve's course.
• While imaging detects organic lesions, many UVCP cases remain idiopathic.

Conclusions:

• Imaging is crucial for pinpointing the location and nature of nerve damage causing UVCP.
• A systematic diagnostic approach ensures comprehensive evaluation of potential lesions.
• Accurate radiological assessment significantly impacts patient management strategies.