Atrophy of the Posterior Cricoarytenoid Muscle as an Indicator of Recurrent Laryngeal Nerve Palsy
Laura Vitale Romo
,a and
Hugh D. Curtina
a From the Department of Radiology, Massachusetts Eye and Ear Infirmary, Boston (L.V.R.), and the Department of Radiology, Brigham and Women's Hospital, Boston (L.V.R., H.D.C.).
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FIG 1. A, Axial depiction of the PCA muscle.
B, Equivalent axial CT scan (black arrow indicates PCA muscle; white arrow, collapsed laryngeal pharynx). Note thin black line of fat between muscle and pharynx (arrowhead indicates inferior constrictor muscle).
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FIG 2. Diagram of the posterolateral view of the laryngeal skeleton (right thyroid lamina removed) shows the PCA muscle (middle arrow) arising from the cricoid lamina (lower arrow) posteriorly and inserting on the arytenoid cartilage (upper arrow). Reproduced from (5) with permission
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FIG 3. A, Axial CT scan in a patient with left vocal cord paralysis shows enlargement of the left piriform sinus (white arrow) and anteromedial deviation of the arytenoid cartilage (black arrow).
B, Axial CT scan in the same patient shows atrophy of the left thyroarytenoid muscle as evidenced by enlargement of the left laryngeal ventricle (white arrow) relative to the right.
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FIG 4. A and B, Two consecutive axial CT scans in a patient with a right-sided glomus vagale show atrophy of the right PCA muscle and right cricothyroid muscle relative to the normal left side (arrowhead indicates normal left PCA muscle; arrow, normal left cricothyroid muscle)
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FIG 5. Axial CT scan in a patient with left vocal cord paralysis shows atrophy of the left PCA muscle (arrow indicates normal right PCA muscle; arrowhead, laryngeal pharynx).
FIG 6. T1-weighted axial MR image (800/12) in a patient with a right-sided vagal schwannoma shows atrophy of the right PCA muscle relative to the left (arrowhead indicates normal left PCA muscle).
FIG 7. Axial CT scan through the level of the PCA muscles in a patient with a left-sided vocal cord paralysis. Atrophy of the left PCA muscle is probably present (a rating of 3) although poorly seen, given the lack of fat posterior to it.
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