title: Prevalence of vocal cord paralysis in patients with incidentally discovered enlarged lymph nodes along the expected course of the recurrent laryngeal nerve.
abstract: OBJECTIVE
  We sought to determine the prevalence of vocal cord paralysis in patients with incidentally discovered lymphadenopathy along the expected course of the recurrent laryngeal nerve (RLN).
  
  
  METHODS
  We reviewed the positron-emission tomographic (PET) and computed tomographic (CT) scans of 936 consecutive patients with a variety of diagnoses. Enlarged lymph nodes (short-axis diameter of more than 1 cm) along the expected course of the RLN were identified. Patients with lymphadenopathy were evaluated for CT signs of vocal cord paralysis. The medical records of patients with lymphadenopathy were reviewed for clinical signs of vocal cord paralysis. Patients with head and neck malignancies were excluded from the study.
  
  
  RESULTS
  Lymphadenopathy along the course of the RLN was identified in 57 of the 936 patients studied. Fifty-three of the 57 patients (93%) were found to have a malignancy. Thirty-four enlarged nodes (60%) had FDG uptake as shown on a PET/CT scan. Twenty enlarged nodes (35%) had CT evidence of extracapsular spread. Four patients (7%) had CT evidence of vocal cord paralysis. One patient (2%) had clinical evidence of vocal cord paralysis.
  
  
  CONCLUSIONS
  In asymptomatic patients with incidental lymphadenopathy along the course of the RLN, vocal cord paralysis is rare.
authors.affiliation: Department of Radiology, George Washington University, 900 23rd St NW, Washington, DC 20037, USA.
authors.forename: Ritu
authors.initials: R
authors.lastname: Agarwal
authors.forename: Justin A
authors.initials: JA
authors.lastname: Ionita
authors.forename: Esma A
authors.initials: EA
authors.lastname: Akin
authors.forename: Nader
authors.initials: N
authors.lastname: Sadeghi
authors.forename: M Reza
authors.initials: MR
authors.lastname: Taheri
mesh_terms: D015331:Cohort Studies; D019788:Fluorodeoxyglucose F18; D006801:Humans; D033162:Incidental Findings; D008206:Lymphatic Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology; D008207:Lymphatic Metastasis; D064847:Multimodal Imaging; D009369:Neoplasms / Q000150:complications; D049268:Positron-Emission Tomography; D015995:Prevalence; D019275:Radiopharmaceuticals; D012009:Recurrent Laryngeal Nerve / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D012507:Sarcoidosis / Q000150:complications; D014057:Tomography, X-Ray Computed; D014481:United States / Q000453:epidemiology; D014826:Vocal Cord Paralysis / Q000000981:diagnostic imaging / Q000453:epidemiology*
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18