Utility of computed tomography for identifying vocal fold motion impairment aetiology

Abstract Objectives Although the role of computed tomography (CT) in vocal fold paralysis is well established, its utility in vocal fold motion impairment remains controversial. We aimed to examine the utility of CT in the aetiological assessment of patients with unexplained vocal fold motion impairment and to identify the underlying pathological causes. Methods We retrospectively reviewed the records of consecutive adults with vocal fold motion impairment who underwent neck CT between June 2010 and March 2023. The CT findings were correlated with management and final diagnoses. Results Computed tomography helped to identify the cause of vocal fold motion impairment in 119 of 177 patients (diagnostic yield, 67.23 per cent). The accuracy, sensitivity and specificity of CT in detecting the underlying causes of vocal fold motion impairment were 96.05, 99.17 and 89.47 per cent, respectively. The leading cause of vocal fold motion impairment was malignancy, followed by idiopathic disease. Conclusion Computed tomography is highly recommended in patients with unexplained vocal fold motion impairment because of its high accuracy and high diagnostic yield.