Sail sign (larynx)

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The sail sign of the larynx refers to the axial appearance of unilateral dilatation of the laryngeal ventricle due to vocal cord/fold paralysis. It should not be confused with the several other sail signs in radiology.

Radiographic features

CT

Axial images at the level of the glottis show the following findings :

  • anteromedial rotation of the arytenoid cartilage
  • medial position of the posterior vocal cord margin
  • air distension of the laryngeal ventricle

The shape of the airway medially in combination with the unilateral dilated laryngeal ventricle take the appearance of a ship's sail. The sail sign is one of the three most reliable findings to localize side of vocal cord paralysis on neck CT .