TY - JOUR
T1 - Dysphagia Outcomes Following Surgical Management of Unilateral Vocal Fold Immobility in Children
T2 - A Systematic Review
AU - Marvin, Kastley
AU - Coulter, Michael
AU - Johnson, Christopher
AU - Friesen, Tzyynong
AU - Morris, Kimberly
AU - Brigger, Matthew T.
N1 - Publisher Copyright:
© 2022 American Academy of Otolaryngology–Head and Neck Surgery Foundation.
PY - 2023/4
Y1 - 2023/4
N2 - Objective: To assess dysphagia outcomes following surgical management of unilateral vocal fold immobility in children. Data Sources: Ovid Medline, Embase, Web of Science, and CENTRAL databases. Review Methods: A systematic review of the medical literature was performed following the PRISMA guidelines. An a priori protocol was defined to identify all articles that presented quantifiable outcome data in children aged <18 years who underwent surgical treatment to improve glottal competence for dysphagia. Two authors independently determined references meeting the inclusion criteria, extracted data, and assigned levels of evidence. Data were pooled via a random effects model where possible. The quality of studies was graded with the MINORS criteria. Results: An overall 398 publications were screened, with 9 meeting inclusion criteria. A total of 115 patients were included. Of these, 75% had preoperative swallowing symptoms. Surgical intervention for dysphagia included 61 injection laryngoplasties, 11 medialization laryngoplasties, and 10 reinnervations (ansa cervicalis to recurrent laryngeal nerve). The articles consistently reported success in improving dysphagia symptoms, and limited meta-analysis demonstrated a mean improvement after surgical intervention in 79% (95% CI, 67%-91%) of children. The reported rate of minor and major complications was 15% (95% CI, 1%-29%). The MINORS scores ranged from 5 to 12. Conclusion: Surgical management of unilateral vocal fold immobility in properly selected children can be an effective treatment for dysphagia when symptoms are present. Selection of surgical modalities relies on patient- and surgeon-related factors, and the rate of success is high across different interventions in treating these complex children.
AB - Objective: To assess dysphagia outcomes following surgical management of unilateral vocal fold immobility in children. Data Sources: Ovid Medline, Embase, Web of Science, and CENTRAL databases. Review Methods: A systematic review of the medical literature was performed following the PRISMA guidelines. An a priori protocol was defined to identify all articles that presented quantifiable outcome data in children aged <18 years who underwent surgical treatment to improve glottal competence for dysphagia. Two authors independently determined references meeting the inclusion criteria, extracted data, and assigned levels of evidence. Data were pooled via a random effects model where possible. The quality of studies was graded with the MINORS criteria. Results: An overall 398 publications were screened, with 9 meeting inclusion criteria. A total of 115 patients were included. Of these, 75% had preoperative swallowing symptoms. Surgical intervention for dysphagia included 61 injection laryngoplasties, 11 medialization laryngoplasties, and 10 reinnervations (ansa cervicalis to recurrent laryngeal nerve). The articles consistently reported success in improving dysphagia symptoms, and limited meta-analysis demonstrated a mean improvement after surgical intervention in 79% (95% CI, 67%-91%) of children. The reported rate of minor and major complications was 15% (95% CI, 1%-29%). The MINORS scores ranged from 5 to 12. Conclusion: Surgical management of unilateral vocal fold immobility in properly selected children can be an effective treatment for dysphagia when symptoms are present. Selection of surgical modalities relies on patient- and surgeon-related factors, and the rate of success is high across different interventions in treating these complex children.
KW - aspiration
KW - dysphagia
KW - injection laryngoplasty
KW - laryngeal reinnervation
KW - medialization
KW - meta-analysis
KW - paralysis
KW - pediatric
KW - systematic review
KW - unilateral vocal fold immobility
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U2 - 10.1177/01945998221084891
DO - 10.1177/01945998221084891
M3 - Review article
C2 - 35290106
AN - SCOPUS:85126342160
SN - 0194-5998
VL - 168
SP - 602
EP - 610
JO - Otolaryngology - Head and Neck Surgery (United States)
JF - Otolaryngology - Head and Neck Surgery (United States)
IS - 4
ER -