xRead - Swallowing Disorders in the Adult Patient (October 2024)

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S. I. Dhar et al.: Does Medialization Improve Swallowing Function in Patients

Records iden fied through database searching (n = 2888)

Addi onal records iden fied through other sources (n = 26)

Screening Included Eligibility Iden fica on

Records a er duplicates removed (n = 128)

Records screened (n = 2786)

Records excluded (n = 2644)

Full-text ar cles assessed for eligibility (n = 142)

Full-text ar cles excluded, with reasons (n = 133): 74 (56%) - Wrong ar cle type 59 (44%) - Wrong study methods

Studies included in qualita ve synthesis (n = 9)

Fig. 1 PRISMA 2009 Flow Diagram

Clinical Presentation

Medialization Procedure

The patients’ mean age was 60 (SD = 8 years) across the 7 studies that reported age, and 50% (46/92) of patients were female across the 6 studies that reported sex (Table 1). The most common etiology of the UVFP was iatrogenic from surgery (74/157; 47%) (Table 2). The UVFP was identi fied most frequently by laryngoscopy with stroboscopy (62/157; 39%). The studies utilized a broad variety of meth ods to identify dysphagia before medialization and no single method prevailed (Table 3). Only 3 studies reported when the swallowing evaluation occurred before the procedure, each <1 month before the procedure.

Most studies (6/9; 67%) did not specify when the pro cedure was performed after the initial diagnosis of UVFP. The time intervals that were reported ranged from months to >1 year. At the level of individual stud ies, 4 studies used only injection augmentation, 3 stud ies used medialization thyroplasty, and 2 studies used both (Table 1). When analyzed by number of patients, the majority underwent injection augmentation of the paralyzed vocal fold (92/157; 59%), most commonly reported using Restylane (a form of hyaluronic acid) (20/92, 22%) or autologous fat (20/92, 22%) (Table 1,

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