Cargando…
Surgery for bilateral vocal fold paralysis: Systematic review and meta-analysis
OBJECTIVES: To determine the decannulation rate (DR) and revision surgery rate after surgery for bilateral vocal fold paralysis (BVFP). DATA SOURCES: Five databases (MEDLINE, PubMed, Embase, Web of Science, Scopus) were searched for the period 1908–2020. METHODS: The systematic literature review fol...
Autores principales: | , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9354550/ https://www.ncbi.nlm.nih.gov/pubmed/35937593 http://dx.doi.org/10.3389/fsurg.2022.956338 |
_version_ | 1784763097502711808 |
---|---|
author | Titulaer, Kai Schlattmann, Peter Guntinas-Lichius, Orlando |
author_facet | Titulaer, Kai Schlattmann, Peter Guntinas-Lichius, Orlando |
author_sort | Titulaer, Kai |
collection | PubMed |
description | OBJECTIVES: To determine the decannulation rate (DR) and revision surgery rate after surgery for bilateral vocal fold paralysis (BVFP). DATA SOURCES: Five databases (MEDLINE, PubMed, Embase, Web of Science, Scopus) were searched for the period 1908–2020. METHODS: The systematic literature review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data were pooled using a random-mixed-effects model. Randomized controlled trials and non-randomized studies (case-control, cohort, and case series) were included to assess DR and revision surgery rate after different surgical techniques for treatment of BVFP. RESULTS: The search yielded 857 publications, of which 102 with 2802 patients were included. DR after different types of surgery was: arytenoid abduction (DR 0.93, 95%-confidence interval [CI], 0.86–0.97), endolaryngeal arytenoidectomy (DR 0.92, 95%-CI, 0.86–0.96), external arytenoidectomy (DR 0.94; 95%-CI, 0.71–0.99), external arytenoidectomy and lateralisation (DR 0.87; 95%-CI, 0.73–0.94), laterofixation (DR 0.95; 95%-CI, 0.91–0.97), posterior cordectomy (DR 0.97, 95%-CI, 0.94–0.99), posterior cordectomy and arytenoidectomy (DR 0.98, 95%-CI, 0.93–0.99), posterior cordectomy and subtotal arytenoidectomy (DR 0.98, 95%-CI, 0.88–1.00), posterior cordotomy (DR 0.96, 95%-CI, 0.84–0.99), reinnervation (0.69, 95%-CI, 0.12–0.97), subtotal arytenoidectomy (DR 1.00, 95%-CI, 0.00–1.00) and transverse cordotomy (DR 1.0, 95%-CI, 0.00–1.00). No significant difference between subgroups for DR could be found (Q = 15.67, df = 11, p = 0.1540). The between-study heterogeneity was low (τ2 = 2.2627; τ = 1.5042; I(2) = 0.0%). Studies were at high risk of bias. CONCLUSION: BLVP is a rare disease and the study quality is insufficient. The existing studies suggest a publication bias and the literature review revealed that there is a lack of prospective controlled studies. There is a lack of standardized measures that takes into account both speech quality and respiratory function and allows adequate comparison of surgical methods. |
format | Online Article Text |
id | pubmed-9354550 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-93545502022-08-06 Surgery for bilateral vocal fold paralysis: Systematic review and meta-analysis Titulaer, Kai Schlattmann, Peter Guntinas-Lichius, Orlando Front Surg Surgery OBJECTIVES: To determine the decannulation rate (DR) and revision surgery rate after surgery for bilateral vocal fold paralysis (BVFP). DATA SOURCES: Five databases (MEDLINE, PubMed, Embase, Web of Science, Scopus) were searched for the period 1908–2020. METHODS: The systematic literature review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data were pooled using a random-mixed-effects model. Randomized controlled trials and non-randomized studies (case-control, cohort, and case series) were included to assess DR and revision surgery rate after different surgical techniques for treatment of BVFP. RESULTS: The search yielded 857 publications, of which 102 with 2802 patients were included. DR after different types of surgery was: arytenoid abduction (DR 0.93, 95%-confidence interval [CI], 0.86–0.97), endolaryngeal arytenoidectomy (DR 0.92, 95%-CI, 0.86–0.96), external arytenoidectomy (DR 0.94; 95%-CI, 0.71–0.99), external arytenoidectomy and lateralisation (DR 0.87; 95%-CI, 0.73–0.94), laterofixation (DR 0.95; 95%-CI, 0.91–0.97), posterior cordectomy (DR 0.97, 95%-CI, 0.94–0.99), posterior cordectomy and arytenoidectomy (DR 0.98, 95%-CI, 0.93–0.99), posterior cordectomy and subtotal arytenoidectomy (DR 0.98, 95%-CI, 0.88–1.00), posterior cordotomy (DR 0.96, 95%-CI, 0.84–0.99), reinnervation (0.69, 95%-CI, 0.12–0.97), subtotal arytenoidectomy (DR 1.00, 95%-CI, 0.00–1.00) and transverse cordotomy (DR 1.0, 95%-CI, 0.00–1.00). No significant difference between subgroups for DR could be found (Q = 15.67, df = 11, p = 0.1540). The between-study heterogeneity was low (τ2 = 2.2627; τ = 1.5042; I(2) = 0.0%). Studies were at high risk of bias. CONCLUSION: BLVP is a rare disease and the study quality is insufficient. The existing studies suggest a publication bias and the literature review revealed that there is a lack of prospective controlled studies. There is a lack of standardized measures that takes into account both speech quality and respiratory function and allows adequate comparison of surgical methods. Frontiers Media S.A. 2022-07-22 /pmc/articles/PMC9354550/ /pubmed/35937593 http://dx.doi.org/10.3389/fsurg.2022.956338 Text en © 2022 Titulaer, Schlattmann and Guntinas-Lichius. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Surgery Titulaer, Kai Schlattmann, Peter Guntinas-Lichius, Orlando Surgery for bilateral vocal fold paralysis: Systematic review and meta-analysis |
title | Surgery for bilateral vocal fold paralysis: Systematic review and meta-analysis |
title_full | Surgery for bilateral vocal fold paralysis: Systematic review and meta-analysis |
title_fullStr | Surgery for bilateral vocal fold paralysis: Systematic review and meta-analysis |
title_full_unstemmed | Surgery for bilateral vocal fold paralysis: Systematic review and meta-analysis |
title_short | Surgery for bilateral vocal fold paralysis: Systematic review and meta-analysis |
title_sort | surgery for bilateral vocal fold paralysis: systematic review and meta-analysis |
topic | Surgery |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9354550/ https://www.ncbi.nlm.nih.gov/pubmed/35937593 http://dx.doi.org/10.3389/fsurg.2022.956338 |
work_keys_str_mv | AT titulaerkai surgeryforbilateralvocalfoldparalysissystematicreviewandmetaanalysis AT schlattmannpeter surgeryforbilateralvocalfoldparalysissystematicreviewandmetaanalysis AT guntinaslichiusorlando surgeryforbilateralvocalfoldparalysissystematicreviewandmetaanalysis |