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This study undertakes a cost\u2010effectiveness analysis of tracheostomy versus endoscopic management of BVFP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Cost\u2010effectiveness analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A literature review identified a range of costs and outcomes associated with surgical options for BVFP. Additional costs were derived from Medicare reimbursement data; all were adjusted to 2014 dollars. Cost\u2010effectiveness analysis evaluated both therapeutic strategies in short\u2010term and long\u2010term scenarios. Probabilistic sensitivity analysis was used to assess confidence levels regarding the economic evaluation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The incremental cost effectiveness ratio for endoscopic management versus tracheostomy is $31,600.06 per quality\u2010adjusted life year (QALY), indicating that endoscopic management is the cost\u2010effective short\u2010term strategy at a willingness\u2010to\u2010pay (WTP) threshold of $50,000\/QALY. The probability that endoscopic management is more cost\u2010effective than tracheostomy at this WTP is 65.1%. Threshold analysis demonstrated that the model is sensitive to both utilities and cost in the short\u2010term scenario. When costs of long\u2010term care are included, tracheostomy is dominated by endoscopic management, indicating the cost\u2010effectiveness of endoscopic management at any WTP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Endoscopic management of BVFP appears to be more cost\u2010effective than tracheostomy. Though endoscopic cordotomy and arytenoidectomy require expertise and specialized equipment, this model demonstrates utility gains and long\u2010term cost advantages to an endoscopic strategy. These findings are limited by the relative paucity of robust utility data and emphasize the need for further economic analysis in otolaryngology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>NA <jats:italic>Laryngoscope<\/jats:italic>, 127:691\u2013697, 2017<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.26253","type":"journal-article","created":{"date-parts":[[2016,8,31]],"date-time":"2016-08-31T06:33:35Z","timestamp":1472625215000},"page":"691-697","source":"Crossref","is-referenced-by-count":32,"title":["Surgical management of bilateral vocal fold paralysis: A cost\u2010effectiveness comparison of two treatments"],"prefix":"10.1002","volume":"127","author":[{"given":"Matthew R.","family":"Naunheim","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Massachusetts Eye and Ear Infirmary Boston Massachusetts U.S.A."},{"name":"Department of Otology and Laryngology Harvard Medical School Boston Massachusetts U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Phillip C.","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Massachusetts Eye and Ear Infirmary Boston Massachusetts U.S.A."},{"name":"Department of Otology and Laryngology Harvard Medical School Boston Massachusetts U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramon A.","family":"Franco","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Massachusetts Eye and Ear Infirmary Boston Massachusetts U.S.A."},{"name":"Department of Otology and Laryngology Harvard Medical School Boston Massachusetts U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Blake C.","family":"Alkire","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Massachusetts Eye and Ear Infirmary Boston Massachusetts U.S.A."},{"name":"Department of Otology and Laryngology Harvard Medical School Boston Massachusetts U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark G.","family":"Shrime","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Massachusetts Eye and Ear Infirmary Boston Massachusetts U.S.A."},{"name":"Department of Otology and Laryngology Harvard Medical School Boston Massachusetts U.S.A."},{"name":"Department of Global Health and Population Harvard School of Public Health Boston Massachusetts U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,8,31]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-199809000-00016"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215109990983"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-008-0665-1"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s004050050248"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348949410301105"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/000164800750001206"},{"issue":"7","key":"e_1_2_6_8_1","first-page":"1","article-title":"United States Life Tables, 2010","volume":"63","author":"Arias E","year":"2014","journal-title":"Natl Vital Stat Rep"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2013.41"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25137"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-199903000-00014"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.4137\/CMENT.S15888"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-013-2414-3"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1524-4733.2003.00234.x"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215112001521"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1017\/S002221511100301X"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348940511401205"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-012-2139-8"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2013.3395"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215106000715"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-199908000-00041"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc4887"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-014-0544-7"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlg.0000251585.31778.c9"},{"key":"e_1_2_6_25_1","first-page":"96","article-title":"Tracheostomy and its complications. 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