Does Medialization Improve Swallowing Function in Patients with Unilateral Vocal Fold Paralysis? A Systematic Review

Area of Science:

• Otolaryngology
• Speech-Language Pathology
• Swallowing Disorders

Background:

• Unilateral vocal fold paralysis (UVFP) frequently causes dysphagia and aspiration.
• Treatments like injection augmentation and medialization thyroplasty improve voice but have unclear effects on swallowing.

Approach:

• Systematic review of prospective studies assessing vocal fold medialization in adult UVFP patients.
• Included studies with pre- and post-intervention dysphagia assessments.
• Searched six databases and one clinical trial registry for studies published before 3/13/2020.

Key Points:

• Nine studies (157 patients) met criteria; most common UVFP cause was iatrogenic.
• Majority received injection augmentation; others had medialization thyroplasty.
• Dysphagia assessed via various methods including patient reports and instrumental evaluations.

Conclusions:

• Seven of nine studies showed clinically significant swallowing improvement post-medialization.
• Only four studies demonstrated statistically significant improvement; three did not.
• Limited evidence suggests vocal fold medialization may not consistently improve swallowing function or safety due to heterogeneity and bias.