Presentation
Cervical lymphadenopathy.
Patient Data
Transverse ultrasound image at the level of the vocal cords demonstrating laryngeal structures.
Corresponding axial CT image at the level of vocal cords in a different 34 year old patient.
Case Discussion
Curvilinear and linear array probes with frequencies of 5 to 7.5 MHz are commonly used for ultrasound of the upper airway. Patient is placed in supine position with pillow under the head to extend the neck. Water bath and 3D probe can be used to achieve better visualization.
Vocal cords are best seen through the thyroid cartilage. True cords are delineated medially by the echogenic vocal ligaments. False cords lie more cephalad and are more echogenic than true cords and relatively immobile on phonation in contrast to true cords which deviate medially.
Real time examination of the cords can detect movement of the cord or its absence in case of vocal cord palsy.