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Laryngeal reinnervation for paediatric vocal cord palsy: a systematic review.
Hoey, Andrew W; Hall, Andrew; Butler, Colin; Frauenfelder, Claire; Wyatt, Michelle.
Afiliación
  • Hoey AW; Great Ormond Street Hospital for Children, Great Ormond Street, London, WC1N 3JH, UK. andrew.hoey@nhs.net.
  • Hall A; Great Ormond Street Hospital for Children, Great Ormond Street, London, WC1N 3JH, UK.
  • Butler C; Great Ormond Street Hospital for Children, Great Ormond Street, London, WC1N 3JH, UK.
  • Frauenfelder C; Great Ormond Street Hospital for Children, Great Ormond Street, London, WC1N 3JH, UK.
  • Wyatt M; Great Ormond Street Hospital for Children, Great Ormond Street, London, WC1N 3JH, UK.
Eur Arch Otorhinolaryngol ; 279(12): 5771-5781, 2022 Dec.
Article en En | MEDLINE | ID: mdl-35838782
OBJECTIVE: This systematic review aims to provide an overview of the current evidence-base for paediatric surgical reinnervation in unilateral and bilateral vocal fold palsies in clinical practice. We aim to assess patient demographics, surgical technique and pre- and post-operative outcome measures. METHODS: A systematic literature review was performed and reported according to international PRISMA recommendations. A comprehensive search of PubMed, Embase, and Cochrane CENTRAL databases for relevant publications for all available dates with appropriate MESH search criteria was performed. Articles were categorised by four authors independently. A pooled summative analysis was carried out to allow review of demographic and outcome data. RESULTS: Our systematic PRISMA approach resulted in 19 papers being selected for inclusion and analysis with 179 patients undergoing reinnervation (153 unilateral, 26 bilateral). The youngest patient was 1.9 years. Iatrogenic injury to recurrent laryngeal nerve most common aetiology (65.4% and 19.2% of unilateral and bilateral vocal fold palsies, respectively). Patent ductus arteriosus ligation was the single most common procedure resulting in unilateral vocal fold palsies (43.1% of cases). Statistically significant improvements in subjective and objective outcomes for both voice and swallowing were seen. Meta-analysis was able to be performed on the particularly evident improvements in GRBAS score and Maximum Phonation Time (MPT). GRBAS scores improved by 3.64 (p < 0.01, 95% CI 2.65 to 4.63). MPT showed a statistically significant improvement of 5.26 s (p < 0.05, 95% CI 4.28 to 6.24). No major complications were reported. CONCLUSION: The current published evidence on one-hundred and seventy-nine paediatric surgical reinnervation procedures demonstrates its role as a safe and effective treatment for both unilateral and bilateral vocal fold palsies. Anatomically it has been shown to improve vocal fold tone, bulk and position. Both post-operative voice and swallowing outcomes show improvement as well as associated quality of life measures.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Parálisis de los Pliegues Vocales / Laringe Tipo de estudio: Etiology_studies / Guideline / Systematic_reviews Aspecto: Patient_preference Límite: Child / Humans Idioma: En Revista: Eur Arch Otorhinolaryngol Asunto de la revista: OTORRINOLARINGOLOGIA Año: 2022 Tipo del documento: Article Pais de publicación: Alemania

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Parálisis de los Pliegues Vocales / Laringe Tipo de estudio: Etiology_studies / Guideline / Systematic_reviews Aspecto: Patient_preference Límite: Child / Humans Idioma: En Revista: Eur Arch Otorhinolaryngol Asunto de la revista: OTORRINOLARINGOLOGIA Año: 2022 Tipo del documento: Article Pais de publicación: Alemania