Vocal Cord Paralysis in Pediatric Chiari Malformation: A Systematic Review and Meta-analysis.

IF 2.6 3区 医学 Q1 OTORHINOLARYNGOLOGY
Otolaryngology- Head and Neck Surgery Pub Date : 2024-12-01 Epub Date: 2024-07-02 DOI:10.1002/ohn.884
Brandon J Vilarello, Sarah Maurrasse, Eli Grunstein, Minyoung Jang
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引用次数: 0

Abstract

Objective: Arnold-Chiari Malformation is one possible cause of congenital vocal cord paralysis (VCP). The natural history of VCP in children with Chiari malformation has previously been limited to small case studies. This systematic review seeks to better characterize the prognostic factors that may predict symptom severity and resolution of congenital VCP in children with Arnold-Chiari malformation. We hypothesized that the onset of stridor or VCP at a younger age would be associated with a poorer prognosis and earlier intervention with posterior fossa decompression would be associated with better outcomes.

Data sources: PubMed, Web of Science, Cochrane Library, and bibliographic review.

Review methods: A systematic review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Database search yielded 866 articles. Study abstracts were reviewed by 2 independent examiners. One hundred and seventy-six studies underwent full-text review. The following were extracted: age at onset of stridor or VCP, Chiari malformation type, laryngoscopy findings, type and timing of neurosurgical intervention, and tracheostomy history. Statistical analyses utilized χ2 tests.

Results: Younger age at symptom onset showed statistically significant associations with decreased likelihood for symptom resolution and tracheostomy decannulation. The shorter time interval from symptom onset to neurosurgical intervention was not significantly associated with better outcomes.

Conclusion: This meta-analysis suggests poorer prognosis in those with earlier-onset symptoms, reinforcing prior case series findings. Additional prospective studies are needed to elucidate the natural history and utility of early intervention in children with vocal cord paralysis secondary to Chiari malformation.

小儿Chiari畸形的声带麻痹:系统回顾与元分析
目的:阿诺德-恰里畸形是导致先天性声带麻痹(VCP)的可能原因之一。有关恰里畸形患儿声带麻痹的自然病史,以往仅限于小型病例研究。本系统性综述旨在更好地描述可预测阿诺德-恰里畸形患儿先天性声带麻痹症状严重程度和缓解情况的预后因素。我们假设,较小年龄出现喘鸣或 VCP 与较差的预后有关,而较早进行后窝减压干预与较好的预后有关:PubMed、Web of Science、Cochrane Library和文献综述:综述方法:根据《系统综述和元分析首选报告项目》指南进行系统综述。在数据库中搜索到 866 篇文章。研究摘要由两名独立审查员进行审查。176 项研究进行了全文审阅。研究提取了以下内容:哮鸣音或 VCP 发病年龄、Chiari 畸形类型、喉镜检查结果、神经外科干预的类型和时间以及气管切开史。统计分析采用χ2检验:结果表明:症状出现时的年龄较小与症状缓解和气管切开术取消的可能性降低有统计学意义。从症状发作到神经外科干预的时间间隔越短,预后越好的相关性越小:这项荟萃分析表明,较早出现症状的患者预后较差,这加强了之前的病例系列研究结果。需要进行更多的前瞻性研究,以阐明Chiari畸形继发声带麻痹患儿的自然病史和早期干预的效用。
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来源期刊
Otolaryngology- Head and Neck Surgery
Otolaryngology- Head and Neck Surgery 医学-耳鼻喉科学
CiteScore
6.70
自引率
2.90%
发文量
250
审稿时长
2-4 weeks
期刊介绍: Otolaryngology–Head and Neck Surgery (OTO-HNS) is the official peer-reviewed publication of the American Academy of Otolaryngology–Head and Neck Surgery Foundation. The mission of Otolaryngology–Head and Neck Surgery is to publish contemporary, ethical, clinically relevant information in otolaryngology, head and neck surgery (ear, nose, throat, head, and neck disorders) that can be used by otolaryngologists, clinicians, scientists, and specialists to improve patient care and public health.
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