BACKGROUND: Clinical practice made us suspect that vocal cord palsy (VCP) can be associated with extracranial internal carotid artery (ICA) tortuosity.
OBJECTIVES: To find evidence for a causative relation between ICA tortuosity and VCP.
METHODS: This single-center, retrospective study comprised 66 patients with VCP. A total of 45 patients without VCP served as control group. Patient charts were reviewed for etiology and side of VCP. CT scans were reviewed independently by two radiologists for imprint in the jugular vein (JV) caused by a tortuous ICA, considered an indirect sign of potential vagus nerve affection.
RESULTS: A total of 33 patients had idiopathic VCP. ICA tortuosity causing a JV imprint with >10% JV lumen reduction was found more frequently on the paretic sides of patients with idiopathic VCP (15-24%) than in controls (3-9%), with p<.05 for observer 2 and p=.07 for observer 1. In patients with idiopathic VCP and JV imprint with >10% JV lumen reduction on one or both sides (n = 9), both observers found JV imprint with >10% JV lumen reduction more frequently on the side of VCP (p<.05).
CONCLUSIONS: ICA tortuosity causing a JV imprint may be the cause of VCP in some of the cases of VCP currently regarded as idiopathic.