Comprehensive analysis of vocal cord fixation: Clinical profiles, CT imaging, and laryngeal electromyography outcomes

Abstract

Objective

This study aimed to evaluate the diagnostic efficacy of a comprehensive multimodal approach, integrating clinical profiles, high-resolution CT imaging, and laryngeal electromyography (LEMG), for vocal fold immobilization. It sought to enhance diagnostic precision, differentiate between neurogenic and mechanical etiologies, and improve treatment outcomes while assessing the cost-effectiveness of this strategy.

Materials and methods

A prospective cohort of 59 patients diagnosed with vocal fold immobilization underwent comprehensive evaluation using clinical assessment, CT imaging, and LEMG over two years. High-resolution CT imaging identified structural abnormalities, while LEMG assessed neuromuscular integrity. The data were analyzed to determine diagnostic accuracy, sensitivity, and specificity of individual and combined modalities. Cost-effectiveness was evaluated using incremental cost-effectiveness ratios (ICERs), and outcomes were tracked over a 12-month follow-up period.

Results

The multimodal approach achieved a diagnostic accuracy of 94.6%, significantly outperforming standalone modalities (p < 0.001). CT imaging identified structural anomalies in 76.3% of cases, while LEMG detected neurogenic dysfunction in 82.5% of patients. Combined modalities showed high sensitivity (93.7%) and specificity (95.2%). Tailored interventions, including surgery (42.4%), voice therapy (37.3%), and medical management (20.3%), led to a 42.3-point improvement in Voice Handicap Index scores, compared to 28.7 points for limited diagnostic approaches (p < 0.001). The comprehensive strategy reduced recovery times by 40% and demonstrated cost-effectiveness with an ICER of $8400 per quality-adjusted life year.

Conclusion

Integrating clinical assessment, CT imaging, and LEMG provides superior diagnostic accuracy and treatment outcomes for vocal fold immobilization. This evidence-based, cost-effective strategy establishes a new standard for managing complex laryngeal conditions and underscores the importance of multidisciplinary care.