Systematic Review and Meta-Analysis of Outcomes in Type 1 Thyroplasty Comparing Silastic to Gore-Tex.

IF 2.2 3区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Laryngoscope Pub Date : 2024-11-06 DOI:10.1002/lary.31867
Dylan G Vance, David Z Allen, Amy B Leming, Madisyn Cox, Sonya E Fogg, Sameer H Siddiqui, Hallie R Wilson, Andrew G Tritter
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Abstract

Objective: Type 1 Thyroplasty is a well-established procedure used for medializing an immobile vocal fold. Silastic and Gore-Tex are the two most common materials used to accomplish this, but comparative data on their relative efficacy are scarce. We sought to compare outcomes between Silastic and Gore-Tex implants via systematic review and meta-analysis for unilateral vocal fold immobility.

Methods: We collected available data from PubMed, Embase, and Web of Science on demographics, maximum phonation time (MPT), voice handicap index (VHI-10/30) score, and any other relevant metrics encountered before comparatively evaluating differences in outcomes.

Results: The search yielded 1,534 records with 55 manuscripts ultimately included. There were 41 unique studies that utilized Silastic for a total of 1038 patients. There were 13 unique studies that utilized Gore-Tex for a total of 245 patients. The pooled mean increase in MPT for Silastic patients was 7.8 s (+1.3 SMD) compared with 5.7 s for Gore-Tex (+1.6 SMD). There was significant publication bias present in both analyses. The pooled mean change in VHI-30 with Silastic was -45.4 (62.2%, -2.09 SMD) compared with -51.6 (73.5%, -1.1 SMD) with Gore-Tex. The pooled mean change in VHI-10 with Silastic was -15.6 (54%, -0.46 SMD) compared with -11.6 (43%, -0.86 SMD) with Gore-Tex. There was no significant publication bias present in VHI outcomes.

Conclusions: Silicone and Gore-Tex implants provide adequate and comparable results in TT1. The data supporting this conclusion are limited by follow-up, diversity in outcomes, limited data availability, and publication bias. Future research should be dedicated to comparing implants in a well-randomized environment. Laryngoscope, 2024.

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比较 Silastic 和 Gore-Tex 的 1 型胸廓成形术结果的系统性回顾和元分析。
手术目的第一类声带成形术是一种成熟的声带内侧化手术。硅胶和 Gore-Tex 是最常用的两种材料,但有关其相对疗效的比较数据却很少。我们试图通过系统回顾和荟萃分析,比较硅胶和 Gore-Tex 植入物对单侧声带不动的治疗效果:我们从 PubMed、Embase 和 Web of Science 中收集了有关人口统计学、最大发音时间(MPT)、嗓音障碍指数(VHI-10/30)评分以及在比较评估结果差异之前遇到的任何其他相关指标的可用数据:搜索共获得 1,534 条记录,最终纳入 55 篇手稿。其中有 41 项研究使用了 Silastic 材料,共有 1038 名患者接受了治疗。使用 Gore-Tex 的研究有 13 项,共有 245 名患者。经汇总,Silastic 患者的 MPT 平均延长时间为 7.8 秒(+1.3 SMD),而 Gore-Tex 患者的 MPT 平均延长时间为 5.7 秒(+1.6 SMD)。两项分析均存在明显的发表偏倚。使用 Silastic 时,VHI-30 的汇总平均变化为-45.4(62.2%,-2.09 SMD),而使用 Gore-Tex 时为-51.6(73.5%,-1.1 SMD)。使用 Silastic 时,VHI-10 的汇总平均变化为-15.6(54%,-0.46 SMD),而使用 Gore-Tex 时为-11.6(43%,-0.86 SMD)。VHI结果没有明显的发表偏倚:结论:硅胶和 Gore-Tex 植入体在 TT1 中提供了充分且可比较的结果。支持这一结论的数据受到随访、结果多样性、数据可用性有限和发表偏差的限制。未来的研究应致力于在良好的随机环境中对植入物进行比较。喉镜》,2024 年。
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来源期刊
Laryngoscope
Laryngoscope 医学-耳鼻喉科学
CiteScore
6.50
自引率
7.70%
发文量
500
审稿时长
2-4 weeks
期刊介绍: The Laryngoscope has been the leading source of information on advances in the diagnosis and treatment of head and neck disorders since 1890. The Laryngoscope is the first choice among otolaryngologists for publication of their important findings and techniques. Each monthly issue of The Laryngoscope features peer-reviewed medical, clinical, and research contributions in general otolaryngology, allergy/rhinology, otology/neurotology, laryngology/bronchoesophagology, head and neck surgery, sleep medicine, pediatric otolaryngology, facial plastics and reconstructive surgery, oncology, and communicative disorders. Contributions include papers and posters presented at the Annual and Section Meetings of the Triological Society, as well as independent papers, "How I Do It", "Triological Best Practice" articles, and contemporary reviews. Theses authored by the Triological Society’s new Fellows as well as papers presented at meetings of the American Laryngological Association are published in The Laryngoscope. • Broncho-esophagology • Communicative disorders • Head and neck surgery • Plastic and reconstructive facial surgery • Oncology • Speech and hearing defects
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