Prognostic Value of the Posterior Cricoarytenoid Muscle Atrophy in Computerized Tomography scans for Unilateral Vocal Fold Paralysis Recovery

Abstract

Objectives: To evaluate a prognostic value of the posterior cricoarytenoid (PCA) muscle atrophy observed on neck computed tomography (CT) in patients with unilateral vocal fold paralysis. Study design: Retrospective cohort study Methods: CT images of 87 with unilateral vocal fold paralysis (UVFP) were evaluated to identify the PCA muscle atrophy and to measure the severity of the PCA muscle atrophy in semi-quantitative manner. The grading of the PCA muscle atrophy was compared with the recruitment pattern of laryngeal electromyography (LEMG) and restoration of vocal fold movement. Results: The PCA muscle was identifiable on CT in 73 subjects. Using the PCA muscle atrophy as an indicator of UVFP, we correctly predicted the paralysis in 69 (94.5%). Grade of the PCA muscle atrophy is significantly correlated with recruitment pattern of LEMG. If the positive result is defined as the PCA muscle showed moderate to severe degree of atrophy, we could predict the persistent UVFP in 88% of patients. Conclusions: Our study demonstrated that the PCA muscle atrophy is possible prognostic factor of UVFP with high positive predictive value.