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Surgery for pediatric vocal cord paralysis: a meta-analysis
Matthew T Brigger1, Christopher J Hartnick
1National Naval Medical Center, Bethesda, Maryland, USA.
Summary
For pediatric vocal cord paralysis, external arytenoidopexy and arytenoidectomy are effective surgical options. These procedures are more successful than CO2 laser treatments for decannulation.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Evidence-Based Medicine
Background:
- Bilateral vocal cord paralysis in children presents significant airway challenges.
- Surgical interventions are necessary to restore airway patency.
- Evaluating the efficacy of different surgical techniques is crucial.
Purpose of the Study:
- To systematically evaluate and compare the effectiveness of various surgical procedures for treating pediatric bilateral vocal cord paralysis.
- To determine the optimal surgical approach based on established meta-analysis principles.
Main Methods:
- A comprehensive literature review was performed following a predefined protocol.
- Six relevant studies were identified and included in the meta-analysis.
- Data on primary decannulation rates for different procedures were extracted and analyzed.
Main Results:
- External arytenoidopexy showed a 79% decannulation rate, and external arytenoidectomy showed a 74% rate.
- CO2 laser arytenoidectomy had a 40% decannulation rate.
- External arytenoid procedures demonstrated significantly higher efficacy than CO2 laser procedures (P = 0.02).
Conclusions:
- External arytenoidopexy and external arytenoidectomy are equally effective surgical treatments for pediatric vocal cord paralysis.
- Combined external arytenoid procedures are superior to CO2 laser ablative procedures.
- External procedures are recommended as a preferred first-line treatment option.