A comparison of outcomes in interventions for unilateral vocal fold paralysis: A systematic review.

OBJECTIVES/HYPOTHESIS To critically review current literature comparing interventional approaches for unilateral vocal fold paralysis. STUDY DESIGN Systematic review of the literature. METHODS All English-language literature published in the PubMed database was eligible for inclusion. Inclusion criteria were: 1) the major topic must be a direct comparison of outcomes in interventions for unilateral vocal fold paralysis, 2) the subjects were 18 years or older, and 3) it was original research. Studies involving treatment of bilateral vocal fold paralysis and nonprocedural interventions were excluded. Included studies were categorized according to level of evidence. Outcomes analyzed were acoustic and aerodynamic measures, auditory perceptive evaluation, laryngoscopic findings, and complications. RESULTS Of the 504 studies retrieved from the search strategy, 17 studies met inclusion and exclusion criteria. Overall, four interventional approaches were used for treatment of unilateral vocal fold paralysis: medialization thyroplasty, injection laryngoplasty, arytenoid adduction, and laryngeal reinnervation. Aside from some select improvements in single outcome parameters, overall, the majority of studies show no difference in improvement of outcomes between techniques. CONCLUSIONS Four surgical interventions for unilateral vocal fold paralysis are available for treatment of unilateral vocal cord paralysis. Multiple studies show favorable outcomes, but no significant differences between treatment arms based on perceptual, acoustic, quality of life, and laryngoscopic outcomes. LEVEL OF EVIDENCE NA Laryngoscope, 126:1616-1624, 2016.