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

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Coulter et al 2 22

9 Otolaryngology–Head and Neck Surgery Otolaryngology–Head and Neck Surgery, Vol. 168(1)

Figure4. Forest plot of postoperative success rate for injection laryngoplasty.

Figure5. Forest plot of postoperative success rate for laryngeal framework surgery.

Discussion

complications was evident for LF procedures. Although major complications were quite low for both procedures, the minor complication rate was 5% for IL and 14% for LF. The trend was not statistically significant, but this difference is intuitive and consistent with the invasiveness of the 2 types of procedures. The 2 studies analyzing the effect of LR indicated that a majority of patients with dysphagia had an improve ment in EAT-10 scores, 44,45 but neither study reported complications. A recent systematic review investigated early IL in 582 patients with acute iatrogenic vocal fold paralysis and its effect on aspiration. 28 The authors showed significant improvement in a majority of patients in regard to diet intake or PAS scores but did not perform a quantitative analysis due

Although adequate glottic closure is just 1 variable in achiev ing an effective and safe swallow, surgical improvement of glottal incompetence seems to be beneficial for a majority of patients with UVFI and dysphagia who underwent these pro cedures. The quantitative analysis revealed IL and LF to be similarly efficacious at a high rate with regard to surgical suc cess. The qualitative analysis demonstrated benefit after IL and LF surgery, especially for those with more severe dyspha gia preoperatively who were found to aspirate or were depen dent on nonoral enteral feeding. The complication rate is low regardless of procedure, and serious complications arise much less frequently. It should be noted that a trend toward higher