Arytenoid adduction combined with medialization thyroplasty: an evidence-based review.
OBJECTIVE
Medialization thyroplasty (MT) and arytenoid adduction (AA) are effective treatments for medializing the paralyzed vocal cord, but indications and benefits of each procedure are controversial. We performed a formal evidence-based review to answer this question: In patients with unilateral vocal cord paralysis, does AA combined with MT significantly improve subjective and objective voice outcomes compared with MT alone?Study design We performed a MEDLINE literature search using specific search terms to identify pertinent articles, which were reviewed and graded according to the evidence quality.


RESULTS
We identified 219 potentially pertinent articles; detailed review yielded 10 studies for further analysis. Only 3 studies directly compared MT with AA plus MT: overall, there was no clear benefit in subjective or objective outcomes for AA plus MT.


CONCLUSIONS
Very limited grade C evidence indicates no clear benefit, or lack of benefit, in subjective or objective outcomes if AA is added to MT, compared with MT alone.
The University of Texas-Houston Medical School, Houston, TX, USA.
Michael W
MW
Chester
Michael G
MG
Stewart
D001193:Arytenoid Cartilage / Q000503:physiopathology*; D003680:Deglutition Disorders / Q000209:etiology; D019317:Evidence-Based Medicine; D006801:Humans; D007821:Laryngeal Muscles / Q000503:physiopathology* / Q000601:surgery*; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D013961:Thyroid Gland / Q000601:surgery*; D014826:Vocal Cord Paralysis / Q000150:complications / Q000601:surgery*; D014832:Voice Disorders / Q000209:etiology