E2278. The Voice: A Pictorial Essay of Vocal Cord Procedures
  1. Jose Rodriguez-Vazquez; University of Nebraska Medical Center
  2. Daniel Welch; University of Nebraska Medical Center
  3. Matthew White; University of Nebraska Medical Center
  4. Christopher Byers; University of Nebraska Medical Center
  5. Allyson Pietrok; University of Nebraska Medical Center
  6. Adriana Vargas; University of Puerto Rico
  7. Fernando Rivera; Universidad Central de Caribe
Vocal Cord Paralysis (VCP) can be due to a variety of etiologies and most commonly presents with hoarseness and dysphonia. There are a variety of surgical options that are employed in the treatment of VCP in an attempt to restore phonation and improve airway protection. An awareness of the cross-sectional imaging appearance of the various post-treatment changes associated with injection laryngoscopy and laryngeal framework surgery, as well as related post-surgical complications, will aid in delineating the expected postoperative appearance from potential pathology.

Educational Goals / Teaching Points
The goals of this educational exhibit are to review the relevant anatomy and selected pathology related to VCP, and to illustrate the typical imaging appearance of several common and emerging therapeutic interventional procedures, with correlating laryngoscopic images when available.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
In this educational exhibit, the anatomy of the hypopharynx and larynx, as well as the clinical presentation, pathology, and etiology of VCP are reviewed, with multiple radiological cases illustrating the imaging appearance of common and uncommon etiologies. Then, several common and emerging therapeutic interventional procedures are reviewed, including a brief overview of the indications and technique for each procedure, followed by a case-based review of the relevant imaging features. Associated laryngoscopic images will also be provided. The various imaging appearances and complications of injection laryngoscopy are shown according to injection agent. Next, the imaging features of various laryngeal framework surgical techniques are illustrated, including medialization laryngoplasty, arytenoid adduction, and cricothyroid subluxation.

Cross-sectional imaging can play an important role in the postoperative evaluation of injection laryngoscopy or laryngeal framework surgery. Familiarity with various interventional techniques and the corresponding imaging appearances is crucial in allowing the radiologist to identify postoperative complications.