Optimal Timing and Treatment Modalities of Arytenoid Dislocation and Subluxation: A Meta-Analysis
<i>Background and Objective</i>: 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...
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2025-01-01
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| author | Andrea Frosolini Valeria Caragli Giulio Badin Leonardo Franz Patrizia Bartolotta Andrea Lovato Luca Vedovelli Elisabetta Genovese Cosimo de Filippis Gino Marioni |
| author_facet | Andrea Frosolini Valeria Caragli Giulio Badin Leonardo Franz Patrizia Bartolotta Andrea Lovato Luca Vedovelli Elisabetta Genovese Cosimo de Filippis Gino Marioni |
| author_sort | Andrea Frosolini |
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| description | <i>Background and Objective</i>: 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. <i>Material and methods</i>: 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. <i>Results</i>: 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). <i>Conclusions</i>: 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. |
| format | Article |
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| institution | Kabale University |
| issn | 1010-660X 1648-9144 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj-art-6382c7e03ac8434f9faa4746120e21902025-01-24T13:40:34ZengMDPI AGMedicina1010-660X1648-91442025-01-016119210.3390/medicina61010092Optimal Timing and Treatment Modalities of Arytenoid Dislocation and Subluxation: A Meta-AnalysisAndrea Frosolini0Valeria Caragli1Giulio Badin2Leonardo Franz3Patrizia Bartolotta4Andrea Lovato5Luca Vedovelli6Elisabetta Genovese7Cosimo de Filippis8Gino Marioni9Maxillofacial Surgery Unit, Department of Medical Biotechnologies, University of Siena, 53100 Siena, ItalyOtorhinolaryngology-Head and Neck Surgery, Audiology Program, Department of Diagnostic Clinical and Public Health, University of Modena and Reggio Emilia, 41125 Modena, ItalyOtolaryngology Section, Department of Neuroscience DNS, University of Padova, 35100 Padova, ItalyPhoniatrics and Audiology Unit, Department of Neuroscience DNS, University of Padova, 31100 Treviso, ItalyUnit of Biostatistics, Epidemiology, and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, 35100 Padova, ItalyOtorhinolaryngology Unit, Department of Surgical Specialties, Vicenza Civil Hospital, 36100 Vicenza, ItalyUnit of Biostatistics, Epidemiology, and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, 35100 Padova, ItalyOtorhinolaryngology-Head and Neck Surgery, Audiology Program, Department of Diagnostic Clinical and Public Health, University of Modena and Reggio Emilia, 41125 Modena, ItalyPhoniatrics and Audiology Unit, Department of Neuroscience DNS, University of Padova, 31100 Treviso, ItalyPhoniatrics and Audiology Unit, Department of Neuroscience DNS, University of Padova, 31100 Treviso, Italy<i>Background and Objective</i>: 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. <i>Material and methods</i>: 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. <i>Results</i>: 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). <i>Conclusions</i>: 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.https://www.mdpi.com/1648-9144/61/1/92arytenoid dislocationarytenoid subluxationtreatmentlocal anesthesiageneral anesthesiatime to treatment |
| spellingShingle | Andrea Frosolini Valeria Caragli Giulio Badin Leonardo Franz Patrizia Bartolotta Andrea Lovato Luca Vedovelli Elisabetta Genovese Cosimo de Filippis Gino Marioni Optimal Timing and Treatment Modalities of Arytenoid Dislocation and Subluxation: A Meta-Analysis Medicina arytenoid dislocation arytenoid subluxation treatment local anesthesia general anesthesia time to treatment |
| title | Optimal Timing and Treatment Modalities of Arytenoid Dislocation and Subluxation: A Meta-Analysis |
| title_full | Optimal Timing and Treatment Modalities of Arytenoid Dislocation and Subluxation: A Meta-Analysis |
| title_fullStr | Optimal Timing and Treatment Modalities of Arytenoid Dislocation and Subluxation: A Meta-Analysis |
| title_full_unstemmed | Optimal Timing and Treatment Modalities of Arytenoid Dislocation and Subluxation: A Meta-Analysis |
| title_short | Optimal Timing and Treatment Modalities of Arytenoid Dislocation and Subluxation: A Meta-Analysis |
| title_sort | optimal timing and treatment modalities of arytenoid dislocation and subluxation a meta analysis |
| topic | arytenoid dislocation arytenoid subluxation treatment local anesthesia general anesthesia time to treatment |
| url | https://www.mdpi.com/1648-9144/61/1/92 |
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