Vocal Cord Paralysis: Review of Imaging Appearance and Etiologies

Vocal cord paralysis is often demonstrated as subtle imaging findings that can easily be overlooked and may be unexpected because a significant number of patients are asymptomatic. A wide range of pathology that involve the vagus or recurrent laryngeal nerves can result in vocal cord paralysis by disrupting motor innervation of the larynx. The detection of vocal cord paralysis should not serve as a final diagnosis but rather as an indication to investigate for a causative etiology because paresis may be a harbinger of more serious underlying disease. Thus, a strong grasp of pertinent anatomy, classic imaging findings, and common underlying pathologies of vocal cord paralysis is paramount for the interpreting radiologist.

Learning Objective: Discuss the imaging evaluation of vocal cord paralysis, describe relevant anatomy, and list common causative etiologies.