Robinson S, Pitkäranta A
Helsinki Medical Imaging Centre, University of Helsinki, Haartmaninkatu, Helsinki.
Clin Radiol. 2006 Oct;61(10):863-7. doi: 10.1016/j.crad.2006.02.016.
To compile imaging findings in patients with vocal fold paralysis.
A retrospective analysis of the medical charts of 100 consecutive patients, admitted to our department with vocal fold paralysis was undertaken. After laryngoscopy, patients were referred for radiological work-up depending on their clinical history and clinical findings. Ultrasound of the neck and/or contrast-enhanced spiral computed tomography (CT) of the neck and mediastinum was performed, extending to include the whole chest if necessary. In one patient, CT of the brain and in two patients, magnetic resonance angiography was undertaken. Analysis of the clinical and radiological data was performed to assess the most frequent causes for vocal fold paralysis.
In 66% of patients, the paralysis was related to previous surgery. Thirty-four percent of cases were labelled idiopathic after clinical examination. After imaging and follow-up, only 8% remained unexplained. Nine patients suffered from neoplasms, four from vascular disease, and 12 from infections. One patient developed encephalomyelitis disseminata on follow-up.
Thorough radiological work-up helps to reduce the amount of idiopathic cases of vocal fold paralysis and guides appropriate therapy.
汇编声带麻痹患者的影像学检查结果。
对连续100例因声带麻痹入住我科的患者病历进行回顾性分析。喉镜检查后，根据患者的临床病史和临床表现，安排其进行影像学检查。对颈部进行超声检查和/或对颈部及纵隔进行增强螺旋计算机断层扫描（CT），必要时扫描范围扩大至整个胸部。1例患者进行了脑部CT检查，2例患者进行了磁共振血管造影。对临床和影像学数据进行分析，以评估声带麻痹最常见的病因。
66%的患者麻痹与既往手术有关。34%的病例经临床检查后被标记为特发性。经过影像学检查和随访，只有8%的病例病因不明。9例患者患有肿瘤，4例患有血管疾病，12例患有感染。1例患者在随访中发生播散性脑脊髓炎。
全面的影像学检查有助于减少声带麻痹特发性病例的数量，并指导适当治疗。
