Frosolini Andrea, Caragli Valeria, Badin Giulio, Franz Leonardo, Bartolotta Patrizia, Lovato Andrea, Vedovelli Luca, Genovese Elisabetta, de Filippis Cosimo, Marioni Gino
Maxillofacial Surgery Unit, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy.
Otorhinolaryngology-Head and Neck Surgery, Audiology Program, Department of Diagnostic Clinical and Public Health, University of Modena and Reggio Emilia, 41125 Modena, Italy.
Medicina (Kaunas). 2025 Jan 8;61(1):92. doi: 10.3390/medicina61010092.
: Arytenoid dislocation (AD) and subluxation (AS) impact vocal fold mobility, potentially affecting the quality of life. Their management, including the timing and modality of treatment, remains a subject of research. Our primary objective was to assess and compare the available treatment strategies for AS and AD. : the protocol was registered on PROSPERO (CRD42023407521). Manuscripts retrieved from a previously published systematic review were evaluated. To comprehensively cover the last 25 years, an updated literature search was conducted, screening PubMed, Scopus, and Cochrane databases. Review Methods: We included studies that reported treatment modalities and the time to treatment (TT) for AS/AD, with outcomes objectively evaluated. Data on treatment success were pooled, and the impact of TT on recovery outcomes was analyzed. : Thirteen studies involving 361 patients were included. The majority of cases were attributed to iatrogenic trauma following intubation. Closed reduction (CR) was the primary treatment, with high success rates for both general (success rate: 77%, CI: 62-87%) and local anesthesia (success rate: 89%, CI: 70-97%). The standardized mean difference for the TT effect on treatment outcome was -1.24 (CI: -2.20 to -0.29). : The absence of randomized controlled trials and the overall moderate-to-low quality of the studies highlighted the importance of the finding's careful interpretation. This meta-analysis underscores the effectiveness of CR in managing AS/AD, with both general and local anesthesia yielding high success rates. The findings highlight the importance of TT, suggesting that early intervention is paramount. Future clinical research is needed to further refine these findings and optimize treatment protocols.
杓状软骨脱位（AD）和半脱位（AS）会影响声带活动度，可能影响生活质量。其治疗，包括治疗时机和方式，仍是一个研究课题。我们的主要目的是评估和比较AS和AD的现有治疗策略。该方案已在国际前瞻性注册系统（PROSPERO，注册号：CRD42023407521）上注册。对从之前发表的系统评价中检索到的手稿进行了评估。为全面涵盖过去25年的情况，进行了更新的文献检索，筛选了PubMed、Scopus和Cochrane数据库。综述方法：我们纳入了报告AS/AD治疗方式和治疗时间（TT）且结局经过客观评估的研究。汇总治疗成功的数据，并分析TT对恢复结局的影响。纳入了13项涉及361例患者的研究。大多数病例归因于插管后的医源性创伤。闭合复位（CR）是主要治疗方法，全身麻醉（成功率：77%，可信区间：62%-87%）和局部麻醉（成功率：89%，可信区间：70%-97%）的成功率都很高。TT对治疗结局影响的标准化均差为-1.24（可信区间：-2.20至-0.29）。缺乏随机对照试验以及研究总体质量为中低水平凸显了对研究结果进行谨慎解读的重要性。这项荟萃分析强调了CR在治疗AS/AD方面的有效性，全身麻醉和局部麻醉的成功率都很高。研究结果凸显了TT的重要性，表明早期干预至关重要。未来需要进行临床研究以进一步完善这些结果并优化治疗方案。
