CTICasesVocal Cord Paralysis Secondary to Sarcoidosis
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Imaging findings
Neck and chest CT demonstrate medial deviation of the left posterior vocal fold and air within the left laryngeal ventricle, diagnostic of left vocal cord paralysis. In the chest, there is extensive upper-lobe predominant conglomerate consolidation, perilymphatic nodules, and calcified mediastinal and hilar lymphadenopathy, including lymph nodes in the AP window along the course of the left recurrent laryngeal nerve.
Key takeaways
Left recurrent laryngeal nerve palsy is a rare manifestation of sarcoidosis. It is typically caused by extrinsic compression of the nerve by hyperplastic mediastinal lymph nodes within the aortopulmonary window. Clinicians should evaluate patients presenting with unexplained hoarseness and vocal cord paralysis for granulomatous disease or neoplasm along the entire pathway of the recurrent laryngeal nerve.
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