Optimal Timing and Treatment Modalities of Arytenoid Dislocation and Subluxation: A Meta-Analysis

Area of Science:

• Otolaryngology
• Laryngology
• Surgical Innovation

Background:

• Arytenoid dislocation (AD) and subluxation (AS) significantly impair vocal fold mobility and quality of life.
• Current management strategies for AD and AS require further research, particularly concerning treatment timing and modality.
• Iatrogenic trauma from intubation is a leading cause of AD and AS.

Purpose of the Study:

• To systematically assess and compare various treatment strategies for arytenoid dislocation (AD) and subluxation (AS).
• To analyze the impact of time to treatment (TT) on recovery outcomes for AD and AS.
• To evaluate the success rates of different treatment modalities for AD and AS.

Main Methods:

• A systematic literature search was conducted across PubMed, Scopus, and Cochrane databases, covering the last 25 years.
• Included studies reported objective outcomes for treatment modalities and time to treatment (TT) for AD/AS.
• Data were pooled for meta-analysis to determine treatment success rates and the influence of TT.

Main Results:

• Thirteen studies involving 361 patients were analyzed, with most cases resulting from post-intubation trauma.
• Closed reduction (CR) demonstrated high success rates: 77% under general anesthesia and 89% under local anesthesia.
• A significant impact of time to treatment (TT) on recovery outcomes was observed (SMD: -1.24, CI: -2.20 to -0.29).

Conclusions:

• Closed reduction is an effective treatment for arytenoid dislocation (AD) and subluxation (AS), with comparable success rates for both general and local anesthesia.
• Early intervention (shorter time to treatment) is critical for optimizing recovery outcomes in patients with AD and AS.
• The study highlights the need for high-quality randomized controlled trials to further refine treatment protocols for AD and AS.