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Purpose <p>Unilateral vocal cord paralysis (UVCP) is a debilitating disorder that affects patients’ vocalization and swallowing. Medialization thyroplasty (MT) and injection laryngoplasty (IL) are the most widely used surgical procedures for treating UVCP. This is the first direct meta-analysis on the effectiveness of IL in treating UVCP in comparison with MT.</p> Methods <p>On the 15th of December, 2024, a systematic search was conducted in biomedical databases. Search results were gathered and screened for relevant primary studies. Data were extracted, and inverse variance meta-analysis was conducted whenever applicable using the RevMan software. The results were pooled as mean difference (MD) or standardized MD, each reported with its corresponding 95% confidence interval. Statistical significance was determined when the P-value was under 0.05.</p> Results <p>Thirteen studies that enrolled 896 patients were included (428 underwent IL while 444 underwent MT). A trend towards short- and long-term improvements was noticed in voice jitter with IL (short-term: MD=-0.59, 95% CI: [-1.03, -0.14], <i>P</i> = 0.01; long-term: MD=-0.70, 95% CI: [-1.00, -0.41], <i>P</i> &lt; 0.001) and in voice shimmer with MT (short-term: MD=-2.06, <i>P</i> = 0.003; long-term: MD=-2.51, <i>P</i> = 0.003), likely of the variation in each procedure’s mechanics. Both IL and MT resulted in comparable improvements in the harmonic-to-noise ratio (<i>P</i> = 0.3), the maximum phonation time (<i>P</i> = 0.8), and the voice handicap index (<i>P</i> = 0.6) within six months post-operatively.</p> Conclusion <p>We conclude comparable improvements in UVCP with both IL and MT. Further long-term studies that investigate this comparison on a large scale are required to provide case-specific conclusions.</p>

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Injection laryngoplasty versus medialization thyroplasty for unilateral vocal cord paralysis: a comprehensive systematic review and meta-analysis

  • 期刊论文

  • 发表日期：

    2025年10月24日

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  • Mohammed H. Baali,
  • Manal A. Bukhari,
  • Mohammed I. Almohizea,
  • Sara. A. Almansour,
  • Mohammad H. Shaheen,
  • Shrooq H. Alswat

摘要

Purpose

Unilateral vocal cord paralysis (UVCP) is a debilitating disorder that affects patients’ vocalization and swallowing. Medialization thyroplasty (MT) and injection laryngoplasty (IL) are the most widely used surgical procedures for treating UVCP. This is the first direct meta-analysis on the effectiveness of IL in treating UVCP in comparison with MT.

Methods

On the 15th of December, 2024, a systematic search was conducted in biomedical databases. Search results were gathered and screened for relevant primary studies. Data were extracted, and inverse variance meta-analysis was conducted whenever applicable using the RevMan software. The results were pooled as mean difference (MD) or standardized MD, each reported with its corresponding 95% confidence interval. Statistical significance was determined when the P-value was under 0.05.

Results

Thirteen studies that enrolled 896 patients were included (428 underwent IL while 444 underwent MT). A trend towards short- and long-term improvements was noticed in voice jitter with IL (short-term: MD=-0.59, 95% CI: [-1.03, -0.14], P = 0.01; long-term: MD=-0.70, 95% CI: [-1.00, -0.41], P < 0.001) and in voice shimmer with MT (short-term: MD=-2.06, P = 0.003; long-term: MD=-2.51, P = 0.003), likely of the variation in each procedure’s mechanics. Both IL and MT resulted in comparable improvements in the harmonic-to-noise ratio (P = 0.3), the maximum phonation time (P = 0.8), and the voice handicap index (P = 0.6) within six months post-operatively.

Conclusion

We conclude comparable improvements in UVCP with both IL and MT. Further long-term studies that investigate this comparison on a large scale are required to provide case-specific conclusions.