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Diagnostic yield of computed tomography in the evaluation of unilateral vocal fold palsy

Published online by Cambridge University Press:  02 March 2021

H S Chew*
Affiliation:
Department of Otorhinolaryngology, Tan Tock Seng Hospital, Singapore
J C G Goh
Affiliation:
Department of Otorhinolaryngology, Tan Tock Seng Hospital, Singapore
D Y A Tham
Affiliation:
Department of Otorhinolaryngology, Tan Tock Seng Hospital, Singapore
*
Author for correspondence: Dr Chew Hui Sing, Department of Otorhinolaryngology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng S308433, Singapore E-mail: hui_sing_chew@ttsh.com.sg

Abstract

Background

There is a paucity of Asian-based data regarding the diagnostic yield of computed tomography imaging in the initial assessment of idiopathic unilateral vocal fold palsy.

Objectives

To investigate the diagnostic yield of computed tomography in idiopathic unilateral vocal fold palsy cases in an Asian tertiary hospital, and to determine the causative pathologies and positive predictive factors.

Method

A retrospective chart review was conducted of patients (between 2010 and 2018) with a clinical diagnosis of idiopathic unilateral vocal fold palsy who underwent contrast-enhanced computed tomography of the neck and chest at Tan Tock Seng Hospital, Singapore.

Results

The overall computed tomography diagnostic yield was 21 per cent, with malignancy accounting for 63.6 per cent of diagnoses. Degree of vocal fold weakness was the only significant predictor of positive computed tomography findings (11.5 per cent in vocal fold paresis vs 29.1 per cent in vocal fold paralysis, p = 0.025). None of the patients with negative computed tomography findings went on to develop disease after a mean follow up of 14.3 months.

Conclusion

Computed tomography is a useful initial investigation for idiopathic unilateral vocal fold palsy, particularly in cases with vocal fold paralysis.

Type
Main Articles
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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Footnotes

Dr HS Chew takes responsibility for the integrity of the content of the paper

Presented at the 5th Congress of European Confederation of Otorhinolaryngology and Head and Neck Surgery, 29 June – 3 July 2019, Brussels, Belgium.

References

Wang, CP, Chen, TC, Lou, PJ, Yang, TL, Hu, YL, Shieh, MJ et al. Neck ultrasonography for the evaluation of the etiology of adult unilateral vocal fold paralysis. Head Neck 2012;34:643–8CrossRefGoogle ScholarPubMed
Altman, JS, Benninger, MS. The evaluation of unilateral vocal fold immobility: is chest X-ray enough? J Voice 1997;11:364–7CrossRefGoogle Scholar
Kang, BC, Roh, JL, Lee, JH, Jung, JH, Choi, SH, Nam, SY et al. Usefulness of computed tomography in the etiologic evaluation of adult unilateral vocal fold paralysis. World J Surg 2013;37:1236–40CrossRefGoogle ScholarPubMed
Paddle, PM, Mansor, MB, Song, PC, Franco, RA Jr. Diagnostic yield of computed tomography in the evaluation of idiopathic vocal fold paresis. Otolaryngol Head Neck Surg 2015;153:414–19CrossRefGoogle ScholarPubMed
Badia, PI, Hillel, AT, Shah, MD, Johns, MM 3rd, Klein, AM. Computed tomography has low yield in the evaluation of idiopathic unilateral true vocal fold paresis. Laryngoscope 2013;123:204–7CrossRefGoogle ScholarPubMed
MacGregor, FB, Roberts, DN, Howard, DJ, Phelps, PD. Vocal fold palsy: a re-evaluation of investigations. J Laryngol Otol 1994;108:193–6CrossRefGoogle ScholarPubMed
Yumoto, E, Minoda, R, Hyodo, M, Yamagata, T. Causes of recurrent laryngeal nerve paralysis. Auris Nasus Larynx 2002;29:41–5CrossRefGoogle ScholarPubMed
Chen, DW, Young, A, Donovan, DT, Ongkasuwan, J. Routine computed tomography in the evaluation of vocal fold movement impairment without an apparent cause. Otolaryngol Head Neck Surg 2015;152:308–13CrossRefGoogle ScholarPubMed
Noel, JE, Jeffery, CC, Damrose, E. Repeat imaging in idiopathic unilateral vocal fold paralysis: is it necessary? Ann Otol Rhinol Laryngol 2016;125:1010–14CrossRefGoogle ScholarPubMed
Tsikoudas, A, Paleri, V, El-Badawey, MR, Zammit-Maempel, I. Recommendations on follow-up strategies for idiopathic vocal fold paralysis: evidence-based review. J Laryngol Otol 2012;126:570–3CrossRefGoogle ScholarPubMed