To provide a pictorial review of the course of the vagus & recurrent laryngeal nerve (RLN) Recognising key CT signs of vocal cord paralysis (VCP) To highlight the common pathologies that can occur along the course of RLN from the brainstem to the mediastinum.

Vocal cord palsy/paresis is the paralysis of the true vocal cords which are supplied by the recurrent laryngeal nerve (RLN). Neurological dysfunction can occur anywhere along the course of the nerve, from the brain stem to the mediastinum and thus understanding the course of Vagus and RLN is of paramount importance. It is important to recognise the key CT signs of vocal cord palsy as it may be the only sign of clinically occult pathology. Most patients with vocal cord palsy present with dysphonia but...

Anatomy The recurrent laryngeal nerve is a branch of the Vagus nerve. The path of the nerves are as follows (Figure 1). The Vagus nerve arises from medulla and exits cranium through the jugular foramen along with the cranial nerves IX and XI.In the neck, nerve passes into the carotid sheath along with internal jugular vein and common carotid artery. At base of neck, right and left nerves follow a different path. Right vagus - pass anterior to subclavian artery and gives off right recurrent...

By recognising signs of VCP on imaging and understanding the course of the Vagus & RLN, one will be able to avoid missing a causative pathology which may be more devastating than VCP itself.

A. K. Raofi; Dundee/UK - nothing to disclose S. Hasan; Dundee/UK - nothing to disclose A. Kamalasanan; Dundee/UK - nothing to disclose T. A. P. Sudarshan; Dundee/UK - nothing to disclose

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