Shifa International Hospital, Islamabad, Pakistan.
J Ayub Med Coll Abbottabad. 2023 Oct-Dec;35(4):563-569. doi: 10.55519/JAMC-04-11853.
Causes of vocal cord palsy (VCP) can be identified even before its clinical presentation if a radiologist has knowledge about signs of vocal cord palsy, its various mimics and the anatomy of recurrent laryngeal nerve. Objectives are to know the signs and underlying causes leading to VCP and various mimics which may lead to the false positive diagnosis of VCP.
A retrospective cross-sectional pilot study comprising 54 patients with vocal cord palsy proven by IDL was conducted. 3 groups were identified. The first group comprised missed VCP on cross-sectional imaging. The second group was, of missed cause of VCP in patients with clinical diagnoses. The third group was patients with mimics of the palsy.
Thirteen (76.5%) patients had missed diagnosis due to lack of knowledge of signs and 23.5% due to lack of time, overwork and tiredness. A vigilant search for the cause was not done in 31.6% of patients and in 68.4% of patients, the cause was identified but not correlated. A total of 8 patients had false positive diagnoses due to failure to differentiate from mimics.
There is an increasing trend of missed diagnosis of vocal cord palsy on cross-sectional imaging in patients with established clinical diagnosis due to a lack of knowledge of VCP signs and missed causes along the course of recurrent laryngeal nerve.
如果放射科医生了解声带麻痹（VCP）的征象、各种类似表现以及喉返神经的解剖结构，即使在其临床表现之前，也能确定声带麻痹的原因。目的是了解导致 VCP 的征象和潜在原因，以及可能导致 VCP 误诊的各种类似表现。
对 54 例经 IDL 证实的声带麻痹患者进行回顾性横断面 pilot 研究。将患者分为 3 组。第一组为横断面影像学检查漏诊的 VCP。第二组为临床诊断为 VCP 但漏诊病因的患者。第三组为麻痹的类似表现患者。
13 例（76.5%）患者因缺乏征象和 23.5%的知识而漏诊，因缺乏时间、过度劳累和疲劳而漏诊。31.6%的患者未进行病因的仔细搜索，68.4%的患者确定了病因但未进行相关性分析。8 例患者因未能与类似表现区分而误诊。
由于缺乏对 VCP 征象和喉返神经走行中遗漏病因的了解，在有明确临床诊断的患者中，横断面影像学检查对声带麻痹的漏诊呈上升趋势。
