A Meta‐analysis of Injection Laryngoplasty vs Thyroplasty

Abstract

Objective: Compare the long-term voice outcome following calcium hydroxylapatite injection laryngoplasty (IL) vs silicone medialization laryngoplasty (ML) as the long-term treatment modalities for the treatment of unilateral vocal fold paralysis (UVFP) through a meta-analysis study. Method: A systematic literature review was performed from MEDLINE, Google Scholar, Web of Science, Scopus, and Cochrane between January 1, 1980, and December 31, 2010. Studies reporting voice outcome after IL with calcium hydroxylappatite and/or ML with silicone for the treatment for UVFP were included. The primary outcome measure was change in Voice Handicap Index (VHI). Results: Seven hundred and forty-two abstracts were screened for relevancy. Seventy-one articles were reviewed in detail. Twelve studies satisfied the inclusion criteria. The mean VHI score, following IL (n = 209), improved from 68.36 (±6.88) to 32.24 (±7.33). The mean VHI score, following ML (n = 110), improved from 72.22 (±11.06) to 34.02 (±6.48). The improvement in VHI following both techniques was statistically significant. Conclusion: Injection laryngoplasty with calcium hydroxylapatite and medialization laryngoplasty with silicone offer comparable voice improvement as long-term treatment modalities for UVFP. The choice of procedure should be based on planned duration of medialization, patient’s preference, and physician’s preference.