Abstract
BACKGROUND: To preliminarily investigate the value of the dynamic larynx CT manifestations in predicting the laryngeal nerve damage and the treatment effectiveness, in patients experiencing hoarseness following viral infection. METHODS: In this prospective cohort study, consecutive participants were enrolled between September 2020 and December 2024. All participants with hoarseness following viral infection underwent primary laryngoscopy and dynamic larynx CT scans. Based on classification criteria that assess morphological and positional changes of the vocal fold on both the maximum open and minimum closed phase images, vocal fold deformation types were categorized into three types (I-III). LEMG with interval less than 2 days was performed to determine the laryngeal nerve damage. Non-parametric tests and chi-square tests were used for univariate analyses. Kappa tests were used for consistency analyses. Linear regression was used to fit the data. RESULTS: A total of 42 participants (Median age, 47.5 years; 17 men) were included. There was a moderate consistency between Type III and posterior cricoarytenoid muscle (PCA) injury (k = 0.508, p < 0.001) or multiple nerve branch injuries (k = 0.646, p < 0.001). Type II vocal fold deformation patients had significantly shorter recovery time than type III (2.0 vs. 5.0 months, p < 0.001). Recovery time greater than 3 months was more common in type III than type II (15.0 vs. 3.0 months, p = 0.003). CONCLUSION: In patients experiencing hoarseness following viral infection, the Classification of vocal fold deformation based on dynamic CT may have preliminary potential value in predicting the laryngeal nerve damage and the treatment effect, but larger multi-center studies are needed to confirm these findings. TRIAL REGISTRATION: IRB-2020-019, 25-Mar-2020.