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European Archives of... Dec 2022This systematic review aims to provide an overview of the current evidence-base for paediatric surgical reinnervation in unilateral and bilateral vocal fold palsies in... (Meta-Analysis)
Meta-Analysis
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.
Topics: Humans; Child; Vocal Cord Paralysis; Quality of Life; Recurrent Laryngeal Nerve; Vocal Cords; Larynx
PubMed: 35838782
DOI: 10.1007/s00405-022-07471-y -
International Journal of Environmental... Apr 2023Sulcus vocalis (SV) is a longitudinal groove in the free edge of the true vocal cord. It may impair phonation with incomplete glottic closure, phonasthenia and...
BACKGROUND
Sulcus vocalis (SV) is a longitudinal groove in the free edge of the true vocal cord. It may impair phonation with incomplete glottic closure, phonasthenia and hoarseness. This study aims to detect a correlation between benign vocal cord lesions and the incidence of the SV.
METHODS
A retrospective study was carried out on patients who underwent transoral surgery due to benign vocal fold lesions and were selected according to strict criteria. Patients were divided into a group with sulcus vocalis (Group wSV) and a group without sulcus vocalis (Group w/oSV). The possible correlations between variables were assessed by the Pearson chi-square test ( < 0.05).
RESULTS
The study included 232 vocal cord lesions in 229 patients: 62.88% were females whose mean age was 46.61 ± 14.04. The most frequent diseases were polyps (37.94%), nodules (18.53%) and Reinke's edema (21.12%). Statistically significant relationships were found between age and SV (-value 0.0005) and between mild dysplasia and SV (-value 0.03).
CONCLUSIONS
This study did not detect a cause-effect relationship between SV and benign vocal fold lesions. SV within vocal fold lesions is more common in younger patients, suggesting a congenital nature of SV. In conclusion, in the case of a benign vocal fold lesion, a possible SV should be considered and researched to provide the patient the best healthcare.
Topics: Female; Humans; Adult; Middle Aged; Male; Vocal Cords; Laryngeal Diseases; Retrospective Studies; Phonation; Polyps
PubMed: 37174173
DOI: 10.3390/ijerph20095654 -
HNO Jan 2022
Topics: Humans; Laryngoscopy; Vocal Cord Paralysis; Vocal Cords
PubMed: 33728500
DOI: 10.1007/s00106-021-01024-1 -
Revue Des Maladies Respiratoires Jan 2018Vocal cord dyskinesia or vocal cord dysfunction (VCD) is characterized by intermittent abnormal adduction of the vocal cords leading to airflow limitation at the level...
INTRODUCTION
Vocal cord dyskinesia or vocal cord dysfunction (VCD) is characterized by intermittent abnormal adduction of the vocal cords leading to airflow limitation at the level of the larynx, in the absence of local organic disease. It may occur in isolation or in association with asthma. The pathophysiology is complex and poorly understood. Wheeze, stridor or apparent upper airway obstruction are the most common symptoms. It occurs in a wide age range, more commonly in women, and diagnosis is often delayed and leads to unnecessary treatments (intubation, tracheostomy and high dose steroids).
METHODS
A retrospective study of 15 cases of VCD (8 cases of isolated VCD and 7 cases of VCD with associated asthma) describing the main clinical features and the diagnosis strategy.
RESULTS
Apparent upper airway obstruction, with or without associated asthma, requires an ear nose and throat examination with laryngoscopy to confirm the paradoxical adduction of the vocal cords during an acute episode of dyspnoea or during a provocation test with triggers like exercise or exposure to irritants, and for the purpose of differential diagnosis.
CONCLUSIONS
VCD remains under-appreciated and misdiagnosed, often by mimicking asthma with which it can be associated. A delayed diagnosis by emergency specialists, pulmonologists and ear nose and throat surgeons leads to unnecessary treatments and morbidity before specific therapy can be given.
Topics: Adolescent; Adult; Aged; Asthma; Diagnosis, Differential; Dyskinesias; Dyspnea; Female; Humans; Laryngoscopy; Male; Middle Aged; Respiratory Sounds; Retrospective Studies; Vocal Cord Dysfunction; Vocal Cords; Young Adult
PubMed: 29397301
DOI: 10.1016/j.rmr.2017.11.001 -
The Medical Journal of Malaysia Dec 2008Laryngeal hemangiomas are relatively rare. Laryngeal hemangiomas occur in two main forms--infantile and adult laryngeal hemangiomas. While infantile hemangiomas are...
Laryngeal hemangiomas are relatively rare. Laryngeal hemangiomas occur in two main forms--infantile and adult laryngeal hemangiomas. While infantile hemangiomas are usually found to occur in the subglottis, adult hemangiomas occur commonly in the supraglottic regions of the larynx. Laryngeal hemangioma with cavernous features isolated to the free edge of the vocal fold is a very rare clinical finding. We present a case of hemangioma of the right vocal cord in an adult, which was managed successfully in our center.
Topics: Adult; Female; Hemangioma; Humans; Laryngeal Neoplasms; Microsurgery; Vocal Cords
PubMed: 19803307
DOI: No ID Found -
Revista Espanola de Patologia :... 2021Inflammatory myofibroblastic tumour (IMT) is a rare entity that can occur in practically any location. Although it has an increased incidence in infancy and adolescence,... (Review)
Review
Inflammatory myofibroblastic tumour (IMT) is a rare entity that can occur in practically any location. Although it has an increased incidence in infancy and adolescence, cases of IMT in the head and neck are more frequent in adults. We report the case of a 74-year-old male who presented with a two month history of dysphonia. Laryngoscopy and cervical TAC revealed a nodular lesion affecting the anterior half of the left vocal cord. He underwent endoscopic laser cordectomy. Histopathology concluded that the lesion was an IMT. Cases of IMT in the head and neck are infrequent and in the vocal cord extremely rare, with only a few previously reported cases.
Topics: Aged; Dysphonia; Granuloma, Plasma Cell; Humans; Laryngeal Neoplasms; Male; Tomography, X-Ray Computed; Vocal Cords
PubMed: 34175030
DOI: 10.1016/j.patol.2019.09.004 -
Intensive Care Medicine Dec 2018Ultrasound can be used to non-invasively and rapidly examine airway conditions, but vocal cord visualization with the traditional approaches is poor. Our aim was to...
PURPOSE
Ultrasound can be used to non-invasively and rapidly examine airway conditions, but vocal cord visualization with the traditional approaches is poor. Our aim was to compare the accuracies of front-side transverse-axis ultrasound (FTU), lateral-side longitudinal-axis ultrasound (LLU), and the combination of both approaches for vocal cord movement disorder diagnoses (e.g., vocal cord paralysis or arytenoid cartilage dislocation).
METHODS
We compared FTU, LLU, and the combination of both methods for patients in the intensive care unit (ICU). We used nasal fiber-optic endoscopy to confirm vocal cord injury.
RESULTS
Among the 120 patients examined, 24 (20%) had vocal cord paralysis. The visualization rate of vocal cords for FTU was 71.7% (assessable, 86; non-assessable, 34), that for LLU was 88.3% (assessable, 106; non-assessable, 14), and that for the combined approach was 96.7% (assessable, 116; non-assessable, 4). The sensitivities and specificities were 58.3% (14/24) and 75% (72/96) for FTU, 91.7% (22/24) and 87.5% (84/96) for LLU, and 100% (24/24) and 95.8% (92/96) for the combined approach. Visualization rates for LLU were significantly higher than for FTU (P = 0.002); FTU + LLU rates were higher than those for FTU (P = 0.001). The difference between LLU and FTU + LLU was not statistically significant (P = 0.025).
CONCLUSION
LLU can be used to evaluate arytenoid cartilage activity in ICUs, and the results are highly correlated with the diagnosis of nasal fiber-optic endoscopy. The combination of FTU and LLU shows promise as a rapid primary screening method for vocal cord injury.
Topics: Adult; Aged; Arytenoid Cartilage; Critical Care; Female; Humans; Male; Middle Aged; Movement; Sensitivity and Specificity; Ultrasonography; Video Recording; Vocal Cord Paralysis; Vocal Cords
PubMed: 30460501
DOI: 10.1007/s00134-018-5469-1 -
The Journal of Adolescent Health :... Aug 2000
Topics: Adolescent; Asthma; Diagnosis, Differential; Female; Humans; Vocal Cords
PubMed: 10899473
DOI: 10.1016/s1054-139x(99)00088-9 -
Chinese Medical Journal 2014Anterior glottic web is one type of laryngeal stenosis. Previous surgical methods had some drawbacks, such as large surgical trauma, long postoperative recovery time,...
BACKGROUND
Anterior glottic web is one type of laryngeal stenosis. Previous surgical methods had some drawbacks, such as large surgical trauma, long postoperative recovery time, and multiple-stage surgery. This study aimed to explore better treatment to repair anterior glottis web.
METHODS
We performed vocal cord mucosal flap procedure on 32 patients with anterior laryngeal webs. All subjects received vocal cord scar releasing and vocal cord mucosal flap repair and suture under general anesthesia with selfretaining laryngoscope.
RESULTS
All 32 patients completed surgery in one stage, without postoperative laryngeal edema, difficulty in breathing, or other complications. After the surgery, the anterior commissure of vocal cords recovered to a decent triangle shape in 28 patients; however, in four patients there were 2 to 3 mm adhesion residuals on the anterior ends of the vocal cords, accompanied by scar appearance of bilateral vocal cords. The GRB score, voice handicap index scores, and maximum phonation time score significantly improved in all patients after the surgery. There was no evidence of recurrent laryngeal webbing in the 6-month follow-up.
CONCLUSION
Vocal cords mucosal flap repair surgery has the advantages of less trauma, quick recovery, and significant improvement of the voice in the treatment of laryngeal webs.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Child; Female; Humans; Laryngeal Diseases; Male; Middle Aged; Surgical Flaps; Suture Techniques; Vocal Cords; Young Adult
PubMed: 24709183
DOI: No ID Found -
Pathology Dec 2023
Topics: Humans; Vocal Cords; Cystadenoma; Parotid Neoplasms
PubMed: 37558598
DOI: 10.1016/j.pathol.2023.05.014