Department of Otolaryngology-Head and Neck Surgery, Stanford University Medical Center, Stanford, California 94305-5739, USA.
Otolaryngol Head Neck Surg. 2013 Feb;148(2):197-208. doi: 10.1177/0194599812464193. Epub 2012 Oct 16.
To compare the voice outcome of calcium hydroxylapatite (CaHA) injection laryngoplasty (IL) vs silicone medialization thyroplasty (MT) in the treatment of unilateral vocal fold paralysis (UVFP).
Systematic review of English literature from MEDLINE, Google Scholar, Web of Science, Scopus, and the Cochrane library from January 1, 1980, to December 31, 2010.
Included studies reporting voice-related quality of life (Voice Handicap Inventory [VHI]) following IL with CaHA or MT with silicone. The primary outcome measure was the improvement in VHI. The secondary outcome was improvement in maximum phonatory time (MPT).
Of the 742 abstracts screened for relevancy, 24 studies qualified for analysis. The mean (SD) VHI scores were 72.22 (11.06) before MT and 34.02 (6.48) after MT. The mean (SD) VHI scores were 68.36 (6.88) before IL and 32.24 (7.33) after IL. The paired difference mean of VHI improvement was 38.20 (95% confidence interval [CI], 17.05-59.32; P = .007) for MT and 36.11 (95% CI, 29.65-42.57; P = .001) for IL. The mean (SD) MPT scores were 7.40 (3.14) before IL and 13.00 (1.75) after IL. The mean (SD) MPT scores were 6.16 (1.90) before MT and 12.40 (2.72) after MT. The paired difference mean of MPT improvement was 6.23 (95% CI, 4.74-7.73; P < .001) for MT and 5.60 (95% CI, 2.95-8.25; P = .006) for IL.
Injection laryngoplasty with CaHA and MT with silicone appear to achieve comparable voice improvement within 1 year, but a definitive conclusion is limited by a lack of standardized outcome measures.
比较羟基磷灰石（CaHA）注射喉成形术（IL）与硅胶内侧化甲状成形术（MT）治疗单侧声带麻痹（UVFP）的嗓音效果。
系统检索 MEDLINE、Google Scholar、Web of Science、Scopus 和 Cochrane 图书馆 1980 年 1 月 1 日至 2010 年 12 月 31 日的英文文献。
纳入报告 IL 后用 CaHA 或 MT 后用硅胶治疗后嗓音相关生活质量（嗓音障碍指数[VHI]）的研究。主要结局指标为 VHI 改善。次要结局指标为最大发音时间（MPT）改善。
在 742 篇符合相关性的摘要中，有 24 项研究符合分析要求。MT 前的平均（SD）VHI 评分为 72.22（11.06），MT 后为 34.02（6.48）。IL 前的平均（SD）VHI 评分为 68.36（6.88），IL 后为 32.24（7.33）。MT 的 VHI 改善差值平均值为 38.20（95%置信区间[CI]，17.05-59.32；P =.007），IL 的 VHI 改善差值平均值为 36.11（95%CI，29.65-42.57；P =.001）。IL 前的平均（SD）MPT 评分为 7.40（3.14），IL 后为 13.00（1.75）。MT 前的平均（SD）MPT 评分为 6.16（1.90），MT 后为 12.40（2.72）。MT 的 MPT 改善差值平均值为 6.23（95%CI，4.74-7.73；P <.001），IL 的 MPT 改善差值平均值为 5.60（95%CI，2.95-8.25；P =.006）。
在 1 年内，CaHA 注射喉成形术和硅胶内侧化甲状成形术似乎都能获得相当的嗓音改善，但由于缺乏标准化的结局指标，因此无法得出明确的结论。
