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CT Assessment of Vocal Cord Medialization

V.A. Kumara, J.S. Lewinb and L.E. Ginsberga

a Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, Tex
b Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Tex


Figure 1
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  		Fig 1. Postcontrast axial CT image of a flaccid atrophic left vocal cord (arrow). It is paramedian in position, and there is associated dilation of the glottic airway.


Figure 2
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  		Fig 2. A and B, A 57-year-old woman status postresection of cervical esophageal cancer, with left vocal cord paralysis. Preoperative videostroboscopy demonstrates the paralyzed vocal cord (arrow) during abduction (A) and adduction (B). Note the complete lack of glottic closure during vocal cord adduction. A indicates anterior commissure.

C and D, Postoperative videostroboscopy in abduction (C) and adduction (D), in the same patient following medialization thyroplasty performed using a Montgomery Silastic implant. The left vocal fold is now midline, and glottic closure is improved during vocal cord abduction (arrow in C) and adduction (arrow in D). A indicates anterior commissure.


Figure 3
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  		Fig 3. A 57-year-old patient with mediastinal lymphoma resulting in left vocal cord paralysis status postmedialization thyroplasty. Axial CT image (noncontrast) demonstrates the typical attenuated triangular configuration of a Montgomery Silastic implant (arrow).


Figure 4
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  		Fig 4. A 62-year-old patient status postresection of medullary thyroid cancer and right vocal cord medialization with Gore-Tex. Axial, postcontrast CT image demonstrates a heterogeneous hyperattenuated material in the right true vocal cord with a lobulated medial margin (arrow).


Figure 5
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  		Fig 5. A 73-year-old patient with metastatic squamous cell cancer of the esophagus, status post XRT and left-sided Teflon injection. Axial noncontrast CT image demonstrates masslike hyperattenuated material in the left true vocal cord (arrow).


Figure 6
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  		Fig 6. A 71-year-old patient with recurrent papillary thyroid cancer status post fat injection. Axial postcontrast CT image shows an ovoid hypoattenuated mass in the right vocal cord (arrow) with attenuation values corresponding to the surrounding subcutaneous fat (–102 HU).


Figure 7
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  		Fig 7. A and B, Axial and coronal high-resolution CT images of the larynx in a 73-year-old patient with papillary thyroid cancer and left vocal cord paralysis. A left-sided Silastic implant is extruded lateral (large white arrow in A) and inferior to the level of the true vocal cord (large white arrow in B). The block arrow indicates the true vocal cord; small white arrow, inferior thyroid cartilage.





Copyright © 2009 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X