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Office-based Laser Therapy in Reinke's Edema: A Systematic Review and Meta-analysis
Abdul-Latif Hamdan1, Christophe Abi Zeid Daou1, Anthony Ghanem1
1Department of Otolaryngology and Head & Neck Surgery, American University of Beirut, Beirut, Lebanon; Department of Otolaryngology - Head and Neck Surgery, Drexel University College of Medicine; Lankenau Institute for Medical Research.
Objective:
To analyze voice outcomes and lesion regression in patients with Reinke's edema treated in the office with lasers.
Study Design:
Systematic review and meta-analysis METHODS: The search was performed in the Medline, Embase, Medline, Cochrane, and Google Scholar databases using the PRISMA framework. There were no limitations to the year of publication and the search included studies looking at voice outcomes and lesion evolution of in-office laser treatment for Reinke's edema measured through voice-handicap index, acoustic analysis or aerodynamics measures. Risk of bias was assessed using Cochrane's ROBINS-I tool for observational studies. Data analysis was performed SPSS software with a significance level of 5%.
Results:
The initial search identified 650 articles, 6 of which met the inclusion criteria and were analyzed. The total number of participants was 58. Meta-analysis showed significant improvement in VHI-10 scores after in-office laser therapy (95% CI, [-1.46; -0.75]). It also showed significant improvement in jitter, significant increase in fundamental frequency (95% CI, [0.52; 1.71]) and significant decrease in lesion size (95% CI, [-2.03; -0.35]).
Conclusion:
Office-based laser therapy is a reliable alternative to the traditional phono-microsurgery performed in the operating room. Patients show significant improvement in voice outcomes and laryngeal examination.
