Hoarseness is a common symptom indicating an abnormal change in the quality of voice and has a lifetime prevalence of around 30%. There are multiple causes of hoarseness, ranging from acute laryngitis, chronic laryngitis, laryngopharyngeal reflux, functional dysphonia due to vocal overuse or abuse, vocal cord paralysis (VCP), to various pathologies and masses in the larynx. A detailed history and thorough physical examination, and in many cases, laryngoscopy by a clinician are the initial steps in its management. Laryngoscopy should be considered if hoarseness persists for more than 2 weeks without a known benign cause. An Ear Nose and Throat surgeon performs direct visualization by laryngoscopy to rule out VCP or a lesion in the larynx, and it should be performed before ordering any imaging. CT with contrast is the imaging of choice to evaluate the laryngeal tumors and find the etiology of VCP. Typical findings of VCP are ipsilateral dilatation of the pyriform sinus and laryngeal ventricle, thickening and medialization of the ipsilateral aryepiglottic fold, medialization of the arytenoid cartilage and posterior aspect of the true vocal cord (TVC) atrophy of the TVC, and loss of the subglottic arch. The lesions causing the VCP may extend from the medulla, jugular foramen, carotid space, and upper mediastinum. CT neck must cover the aorticopulmonary window when evaluating the left VCP to cover the left recurrent laryngeal nerve's origin.

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影像学在声音嘶哑评估中的作用：综述

声音嘶哑是声音质量异常变化的常见症状，终生患病率约为 30%。声音嘶哑有多种原因，从急性喉炎、慢性喉炎、喉咽反流、因过度使用或滥用声音导致的功能性发音困难、声带麻痹 (VCP) 到喉部的各种病理和肿块。详细的病史和彻底的体格检查，在许多情况下，临床医生的喉镜检查是其管理的初始步骤。如果声音嘶哑持续 2 周以上而没有已知的良性原因，则应考虑进行喉镜检查。耳鼻喉外科医生通过喉镜进行直接可视化以排除 VCP 或喉部病变，并且应在订购任何成像之前进行。增强 CT 是评估喉部肿瘤和发现 VCP 病因的首选影像学检查。VCP 的典型表现是同侧梨状窦和喉室扩张，同侧杓会厌皱襞增厚和内化，杓状软骨内化和真声带 (TVC) 后侧萎缩，以及声门下缺失拱。引起 VCP 的病变可能从髓质、颈静脉孔、颈动脉间隙和上纵隔延伸。在评估左侧 VCP 以覆盖左侧喉返神经的起源时，CT 颈部必须覆盖主肺动脉窗。同侧杓会厌皱襞的增厚和内侧化，杓状软骨的内侧化和真声带（TVC）的后部萎缩，以及声门下弓的丧失。引起 VCP 的病变可能从髓质、颈静脉孔、颈动脉间隙和上纵隔延伸。在评估左侧 VCP 以覆盖左侧喉返神经的起源时，CT 颈部必须覆盖主肺动脉窗。同侧杓会厌皱襞的增厚和内侧化，杓状软骨的内侧化和真声带（TVC）的后部萎缩，以及声门下弓的丧失。引起 VCP 的病变可能从髓质、颈静脉孔、颈动脉间隙和上纵隔延伸。在评估左侧 VCP 以覆盖左侧喉返神经的起源时，CT 颈部必须覆盖主肺动脉窗。