{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T06:27:46Z","timestamp":1791008866254,"version":"4.1.0"},"reference-count":33,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2020,10,3]],"date-time":"2020-10-03T00:00:00Z","timestamp":1601683200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>To identify the incidence and nature of positive findings on imaging studies ordered for evaluation of unilateral vocal fold paralysis (UVFP) of unknown etiology, to analyze these findings based on laterality, and to examine the use of the expanded\u2010field computed tomography (CT) neck protocol in this evaluation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 145 patients from 2000 to 2018 with UVFP of unknown etiology were studied. Data on imaging studies ordered, laterality of paralysis, and significant positive results were studied. An expanded\u2010field CT neck protocol that included the entire course of the vagus and recurrent laryngeal nerves was instituted during the study period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 20.7% of patients had an etiology for paralysis identified on imaging. Malignancies comprised the majority of findings overall (19\/30), whether in the chest (12\/18) or the neck (7\/12). Etiology was more often found in the chest for left\u2010sided paralysis (15\/21) and in the neck for right\u2010sided paralysis (6\/9). In 26 patients who underwent both expanded\u2010field CT neck and CT chest, no findings related to the UVFP were seen on CT chest that were not captured by expanded\u2010field CT neck.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This is one of the largest retrospective studies examining the incidence of positive findings on imaging studies for evaluation of UVFP of unknown etiology. Imaging in one of five patients with UVFP of unknown etiology will reveal a causative lesion, most often malignant. Left\u2010sided paralysis tends to localize to the chest, and right\u2010sided paralysis to the neck. Expanded\u2010field CT neck may allow practitioners to forego dedicated CT chest in evaluation of UVFP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 131:1840\u20131844, 2021<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.29152","type":"journal-article","created":{"date-parts":[[2020,10,3]],"date-time":"2020-10-03T11:38:18Z","timestamp":1601725098000},"page":"1840-1844","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Yield of Imaging to Evaluate Unilateral Vocal Fold Paralysis of Unknown Etiology"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4103-7702","authenticated-orcid":false,"given":"Stephen","family":"Politano","sequence":"first","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery The Ohio State University Wexner Medical Center  Columbus Ohio 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