Evidence map›Paper›PMID 35412149›Full record

SynthesisDysphagia2022

Does Medialization Improve Swallowing Function in Patients with Unilateral Vocal Fold Paralysis? A Systematic Review.

Shumon I Dhar, Marisa A Ryan, Ashley C Davis, Erin Jedlanek, Kristine Pietsch, Carrie Price, Martin B Brodsky, Lee M Akst

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Dysphagia, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
2.3field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 9 citations in OpenAlex.

  1. Early injection laryngoplasty improves swallowing outcomes in inpatients with acute vocal fold motion impairment.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2026
    Article
  2. Aspiration prevention surgeries: a review.Respiratory research · 2023
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Shumon I DharDepartment of Otolaryngology - Head & Neck Surgery, UT Southwestern Medical Center, 2001 Inwood Road, Dallas, TX, 75390, USA. Shumon.Dhar@UTSouthwestern.edu.ORCID 0000-0001-9873-8641
Marisa A RyanJohns Hopkins University, 601 North Caroline Street, Baltimore, MD, 21287, USA.
Ashley C DavisJohns Hopkins University, 601 North Caroline Street, Baltimore, MD, 21287, USA.
Erin JedlanekDepartment of Physical Medicine and Rehabilitation, Johns Hopkins University, 600 N. Wolfe St. - Meyer 1-160, Baltimore, MD, 21287, USA.
Kristine PietschJohns Hopkins University, 601 North Caroline Street, Baltimore, MD, 21287, USA.
Carrie PriceTowson University, 8000 York Road, Towson, MD, 21252, USA.
Martin B BrodskyDepartment of Physical Medicine and Rehabilitation, Johns Hopkins University, 600 N. Wolfe St. - Meyer 1-160, Baltimore, MD, 21287, USA.
Lee M AkstJohns Hopkins University, 601 North Caroline Street, Baltimore, MD, 21287, USA.
Johns Hopkins University · USSouthwestern Medical Center · USTowson University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Glottal incompetence caused by unilateral vocal fold paralysis (UVFP) is a common cause of dysphagia and aspiration. Treatments targeted at reducing glottal incompetence by injection augmentation or medialization thyroplasty are well established at improving voice outcomes, but improvements in swallowing function are less clear. The objective of this systematic review was to determine the impact of vocal fold medialization on dysphagia outcomes. Six electronic bibliographic databases and one clinical trial registry were searched on 3/13/2020. Our patient population were adult patients with verified UVFP that underwent vocal fold medialization. We limited review to prospective studies that had formal dysphagia assessment both before and after medialization. Nine studies met selection criteria (7 prospective case series and 2 prospective cohort studies) totaling 157 patients. The most common etiology of UVFP was iatrogenic (74/157; 47%). The majority of patients underwent injection augmentation (92/157; 59%), and the remaining underwent medialization thyroplasty. A variety of methods were used to assess changes in dysphagia including patient-reported outcome measures, flexible endoscopic evaluation of swallowing, videofluoroscopic swallow study, and high-resolution manometry. 7/9 studies demonstrated clinically significant improvement in swallowing function following medialization; 4/9 studies demonstrated statistically significant improvement, and three studies did not show statistically significant improvement after intervention. Study participants and outcome measures evaluating swallowing function in this review were heterogeneous. Moreover, the reviewed studies are concerning for multiple risks of bias impacting their conclusions. Taken together, this systematic review demonstrates limited evidence that injection augmentation and medialization thyroplasty improve swallowing function and/or safety.

Indexed as

Deglutition DisordersVocal Cord ParalysisAdultDeglutitionHumansProspective StudiesTreatment OutcomeVocal CordsAspirationDeglutitionDeglutition disordersDysphagiaSystematic reviewVocal fold augmentationVocal fold paralysis

Identifiers

PMID35412149
OpenAlexW4223556793

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.