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Management Of Arytenoid Dislocation: A Systematic Review
Sanjay Morzaria1, Feifan Wang2, Caroline Worthington3
1Division of Laryngology, Department of Otolaryngology-Head & Neck Surgery, Stanford University School of Medicine, Stanford, California, United States of America; Otolaryngology - Head and Neck Surgery, Department of Surgery, Surrey Memorial Hospital, University of British Columbia, Surrey, British Columbia, Canada.
Arytenoid dislocation (AD) and subluxation (AS) diagnosis and treatment are challenging. Early intervention and closed reduction offer high success rates for improved voice outcomes in AD/AS cases.
Area of Science:
- Otolaryngology
- Laryngology
- Surgical Diagnosis
Background:
- Arytenoid dislocation (AD) and subluxation (AS) present diagnostic and therapeutic challenges.
- Intraoperative confirmation is crucial for accurate diagnosis of AD/AS.
Purpose of the Study:
- To provide an evidence-based approach to diagnosing and managing AD/AS.
- To analyze outcomes based on intraoperative findings.
Main Methods:
- Systematic literature review of human adult studies with intraoperative confirmation of AD/AS.
- Data extraction included etiology, presentation, diagnostic imaging (CT), electrophysiology (LEMG), treatment, timing, and voice outcomes.
- Descriptive synthesis and regression analysis were performed.
Main Results:
- 77 cases from 22 studies identified; common causes include intubation and trauma.
- CT sensitivity was 71%, LEMG 54%; combined sensitivity 59%.
- Closed reduction yielded normal voice in 67.6%; early intervention correlated with better voice outcomes (P=0.048).
Conclusions:
- Intraoperative palpation is the gold standard for AD/AS diagnosis, though imaging can assist.
- Closed reduction is highly successful for AD/AS treatment.
- Timely intervention significantly improves voice outcomes in AD/AS patients.
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