Dysphagia Outcomes Following Surgical Management of Unilateral Vocal Fold Immobility: A Systematic Review and Meta-analysis.
Otolaryngol Head Neck Surg
; 168(1): 14-25, 2023 01.
Article
em En
| MEDLINE
| ID: mdl-35021908
ABSTRACT
OBJECTIVE:
To assess dysphagia outcomes following surgical management of unilateral vocal fold immobility (UVFI) in adults. DATA SOURCES Ovid MEDLINE, Embase, Web of Science, and Cochrane Central. REVIEWMETHODS:
A structured literature search was utilized, and a 2-researcher systematic review was performed following PRISMA guidelines. Extractable data were pooled, and a quantitative analysis was performed with a random effects model to analyze treatment outcome and complications by procedure.RESULTS:
A total of 416 publications were screened and 26 met inclusion criteria. Subjects encompassed 959 patients with UVFI who underwent 916 procedures (n = 547, injection laryngoplasty; n = 357, laryngeal framework surgery; n = 12, laryngeal reinnervation). An overall 615 were identified as having dysphagia as a result of UVFI and had individually extractable outcome data, which served as the basis for a quantitative meta-analysis. In general, dysphagia outcomes after all medialization procedures were strongly positive. Quantitative analysis demonstrated a success rate estimate of 90% (95% CI, 75%-100%) for injection laryngoplasty and 92% (95% CI, 87%-97%) for laryngeal framework surgery. The estimated complication rate was 7% (95% CI, 2%-13%) for injection laryngoplasty and 15% (95% CI, 10%-20%) for laryngeal framework surgery, with minor complications predominating. Although laryngeal reinnervation could not be assessed quantitatively due to low numbers, qualitative analysis demonstrated consistent benefit for a majority of patients for each procedure.CONCLUSION:
Dysphagia due to UVFI can be improved in a majority of patients with surgical procedures intended to improve glottal competence, with a low risk of complications. Injection laryngoplasty and laryngeal framework surgery appear to be efficacious and safe, and laryngeal reinnervation may be a promising new option for select patients.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Transtornos de Deglutição
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Laringoplastia
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Laringe
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article