Dysphagia Outcomes Following Surgical Management of Unilateral Vocal Fold Immobility in Children: A Systematic Review

Marvin, Kastley; Coulter, Michael; Johnson, Christopher M.; Friesen, Tzyynong L.; Morris, Kimberly; Brigger, Matthew T.

doi:10.1177/01945998221084891

Cited by 7 publications

(7 citation statements)

References 44 publications

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“…For this review, a score of <11 was considered a high risk of bias, and a score of

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11 was considered to be a low risk of bias. This scoring has been used in prior systematic reviews in the Otolaryngology literature 9 . The Cochrane risk of bias tool for randomized trials was used for 3 studies (Supplemental Table 1, available online) 10 …”

Section: Methodsmentioning

confidence: 99%

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Current Management of Subcondylar Fractures: A Systematic Review

Shikara

Bridgham

Ludeman

et al. 2023

Otolaryngol.--head neck surg.

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Objective. The aim of this study is to review the current literature on treatment of subcondylar fractures using traditional open reduction internal fixation (ORIF), closed reduction with maxillomandibular fixation (MMF), and endoscopic open approaches.Data Sources. PubMed, Embase, Cochrane CENTRAL, Clinicaltrials.gov, and WHO ICTRP.Review Methods. A comprehensive database search was performed in accordance with PRISMA guidelines. All English-only texts published in the last 20 years with ≥10 patients were included. Studies that included patients <16 years old were excluded.Results. Thirty-two studies met the final inclusion criteria. Nine studies compared ORIF with closed reduction using MMF, 12 studies evaluated ORIF via different approaches, and 10 studies evaluated outcomes after endoscopic approaches. Five studies reported significant improvement in mouth opening with ORIF compared to closed reduction. In 1 study that recorded patient-reported outcomes measure (FACE-Q scale), quality of life scores and patient satisfaction were significantly higher in the ORIF group. Among the 10 studies that used the endoscopic approach, transient facial nerve injury ranged from 0% to 10%. Conclusion.Several studies report better mouth opening, dental occlusion, and functional outcomes after ORIF compared to closed reduction, while some found no significant difference. Endoscopic approaches provide ease of access to the condyle with a low incidence of facial nerve injury. However, limitations include special equipment, longer operative times, and a steep learning curve using an endoscope. This review provides surgeons with an overview of the current literature on subcondylar fractures to allow for an individualized management approach for each patient.

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“…For this review, a score of <11 was considered a high risk of bias, and a score of

\ge

Section: Methodsmentioning

confidence: 99%

“…This scoring has been used in prior systematic reviews in the Otolaryngology literature. 9 The Cochrane risk of bias tool for randomized trials was used for 3 studies (Supplemental Table 1, available online). 10…”

Section: Data Extractionmentioning

confidence: 99%

Current Management of Subcondylar Fractures: A Systematic Review

Shikara

Bridgham

Ludeman

et al. 2023

Otolaryngol.--head neck surg.

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“…We feel it is imperative to emphasize that the co-occurrence of downstream consequences with an anatomic concern is the key in decision-making, as many children have anatomic variants that do not cause functional issues. Anatomic targets for surgical intervention by the otolaryngologist may include ankyloglossia, adenotonsillar hypertrophy, laryngeal cleft, laryngomalacia, vocal fold movement impairment, and cricopharyngeal achalasia [4,22,[30][31][32][33][34].…”

Section: Surgical and Medical Managementmentioning

confidence: 99%

Current opinion in otolaryngology and head and neck surgery: the role of the otolaryngologist in the management of pediatric dysphagia

Farrell,

Raol

2023

Current Opinion in Otolaryngology &Amp; Head &Amp; Neck Surgery

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Purpose of review Dysphagia affects at least 1% of the pediatric population. This prevalence further increases in patients who are born prematurely or who have underlying neuromuscular or cardiopulmonary disorders. A multidisciplinary team approach, including an Otolaryngologist, can help promote an expedited diagnosis and therapeutic regimen, ensuring that the patient receives adequate nutrition needed for growth and development. Recent findings The development and growth of multidisciplinary aerodigestive clinics have improved outcomes in pediatric patients with dysphagia. If a structural concern is noted on examination, there remain a multitude of medical and surgical options to help improve patient outcomes and swallow. These treatment options are usually multimodality and specific interventions may be employed to target a specific and notable abnormality. Summary Pediatric dysphagia is a complex concern. For the otolaryngologist, etiologies with surgical targets may include ankyloglossia, tonsillar hypertrophy, laryngomalacia, laryngo-esophageal cleft, vocal fold movement impairment, and cricopharyngeal achalasia. The development and formalization of a multidisciplinary approach has streamlined and broadened treatment options for these patients. An otolaryngologist is integral as part of the treatment team of these patients.

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“…For this review, a score of <11 was considered high risk of bias and a score of ≥ 11 was considered to be low risk of bias. 46,47…”

Section: Accepted Manuscriptmentioning

confidence: 99%

“…11 was considered to be low risk of bias. 45,46 Outcomes Measures Definitions Several primary outcomes included in this systematic review are based on previously validated outcome measures.…”

Section: Data Extraction and Processingmentioning

confidence: 99%

Selective Neurectomy for Treatment of Post-Facial Paralysis Synkinesis: A Systematic Review

et al. 2022

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Background: Synkinesis is commonly encountered after flaccid facial paralysis and can have a detrimental impact on a patient’s life. First line treatment of synkinesis is chemodenervation with Botulinum toxin (Botox) and neuromuscular retraining. Surgical options include selective myectomy, selective neurectomy (SN), cross-facial nerve grafting, nerve substitution, and free gracilis muscle transfer (FGMT). Data on surgical management of synkinesis using selective neurectomy is limited. Evidence Review PubMed, Embase, Cochrane CENTRAL, Cochrane Neuromuscular Register, Clinicaltrials.gov, and WHO ICTPR were searched using a comprehensive keyword strategy in accordance with PRISMA guidelines. All English-only texts published in the last 20 years were included. Two independent investigators reviewed 906 abstracts and 7 studies met inclusion criteria. Demographics, etiology of paralysis, time to surgery, and primary outcomes studied were collected. Findings A total of 250 patients were included across 7 studies. In 6 out of 7 studies, Botox was used prior to surgical intervention. Two studies showed significant reduction in Botox dosage postoperatively, while one study showed no difference. Other primary outcomes included the House-Brackman Score, palpebral fissure width, eFACE score, Facial Clinimetric Evaluation (FaCE) scale, and Synkinesis Assessment Questionnaire (SAQ). Three studies showed significant improvement in the eFACE score, two studies showed significant improvement in the FaCE scale, while one study showed improvement in quality of life measured by the SAQ. Conclusions Selective neurectomy can be considered as an adjunct to other management options including neuromuscular retraining, Botox, selective myectomy and reanimation procedures. While there is great heterogeneity of study design in the studies included, many cohorts showed improvement in facial symmetry, facial function, and quality of life. There remains a great gap in knowledge in this subject matter and a need for large well designed prospective studies comparing this technique to other management options.

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Dysphagia Outcomes Following Surgical Management of Unilateral Vocal Fold Immobility in Children: A Systematic Review

Cited by 7 publications

References 44 publications

Current Management of Subcondylar Fractures: A Systematic Review

Current Management of Subcondylar Fractures: A Systematic Review

Current opinion in otolaryngology and head and neck surgery: the role of the otolaryngologist in the management of pediatric dysphagia

Selective Neurectomy for Treatment of Post-Facial Paralysis Synkinesis: A Systematic Review

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