Fig. 1

Decision Tree of Cost Minimization comparing Medialization Thyroplasty and Injection Laryngoplasty. The square represents the initial decision to undergo MT or IL after the identification of UVFP. Circles represent chance events, and triangles represent terminal nodes beyond which no further interventions and costs occurred. One month following the procedure (MT or IL), patients were stratified into 3 groups based on the post-procedural outcomes: voice symptoms (V), voice and swallowing symptoms (V & S), and asymptomatic (Asymp). There were no patients who complained of swallowing symptoms without voice symptoms. Patients with symptoms (V or V & S) after the implementation of initial IL have three possible paths: immediate revision IL (Revision IL), MT (Switch to MT), or observation if the patient was satisfied despite their symptomology (Satisfactory). Due to the temporary nature of the fillers used for IL, patients who were initially satisfied with their treatment despite symptomology could have three possible paths: repeat IL (2nd IL), MT (Switch to MT), or observation if the patient remained satisfied despite their symptoms (Remain Satisfactory). Similarly, patients who were asymptomatic after the initial IL could have three possible paths: relapse after the fillers are resorbed over time and have a repeat IL (2nd IL), undergo MT (Switch to MT), or remain asymptomatic (Remain Asymp). MT Subtree: For patients with symptoms (V or V & S) after MT, there were two possible paths: immediate revision MT (Revision MT), or observation if the patient was satisfied despite their symptomology (Satisfactory). For patients who were asymptomatic after MT, there was no further intervention as of MT is considered permanent