World Journal of OtorhinolaryngologyHead and Neck Surgery最新文献

{"title":"Multimodal management of PD-L1 positive sinonasal inverted papilloma with malignant transformation.","authors":"Vanessa Velazquez, Mohamad Nawar Hakim, Hans Brockhoff, Satish Maharaj","doi":"10.1002/wjo2.221","DOIUrl":"10.1002/wjo2.221","url":null,"abstract":"<p><p>Inverted papillomas (IP) are rare sinonasal tumors (Schneiderian papillomas) characterized by local invasion, with high recurrence rates and potential for malignant transformation into squamous cell carcinoma (SCC ex-IP). Traditionally, the mainstay of treatment has been surgical resection, often challenging due to invasion of the skull base or vital neurovascular structures. In advanced cases, prognosis is poorer and radiation therapy is the current standard of care with limited role of systemic therapy. We present a case of unresectable SCC ex-IP treated with sequential chemoradiation and PD-1 immunotherapy (pembrolizumab) and achieving complete response at 1 year. This case suggests that immunotherapy can effectively treat SCC ex-IP and we propose that programmed death ligand-1 (PD-L1) testing should be performed in all advanced cases. Prospective studies are needed to validate immunotherapy in adjuvant or frontline treatments for advanced SCC ex-IP, and the role of PD-L1 as a predictive biomarker.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":"11 3","pages":"477-481"},"PeriodicalIF":1.4,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of non-invasive neuroelectric stimulation of oral cavity for obstructive sleep apnoea: A systematic review.","authors":"Muhammad Ozair Awan, Aahan Arif, Mohammad Adeel, Shahzada Ahmed, Haissan Iftikhar","doi":"10.1002/wjo2.220","DOIUrl":"10.1002/wjo2.220","url":null,"abstract":"<p><strong>Objectives: </strong>With an estimated disease burden of one billion adults aged 30-69, obstructive sleep apnea (OSA) offers considerable challenges in terms of both identification and management Neuroelectric stimulation offers benefit with studies showing improvement in both the respiratory disturbance index and apnoea-hypopnoea index. This systematic review aims to examine the effects of non-invasive neuroelectric stimulation of the oral cavity utilized in the treatment of OSA.</p><p><strong>Methods: </strong>A systematic search of PubMed, EBSCO CINAHL Plus, EBSCO Dentistry and Oral Sciences Source and Wiley Cochrane Library was utilized to identify articles. A total of 4 articles investigating 154 participants were included in the final synthesis. Data was extracted to by two authors (MOA and HI) working independently of each other. Any discrepancies that arose were discussed and resolved.</p><p><strong>Results: </strong>Our results demonstrated that non-invasive neurostimulation serves as an avenue for management that can allow for improvements in functionality as well as oxygen saturation amongst patients suffering from mild to moderate OSA.</p><p><strong>Conclusion: </strong>Due to the dearth of research, it is imperative that further studies are done to investigate the efficacy of neuromuscular stimulation, as these findings cannot be generalized across different populations.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":"11 2","pages":"290-297"},"PeriodicalIF":0.0,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12172099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing vacuum-assisted closure against conventional approach in severe deep neck infection: A retrospective case-control study.","authors":"Mu Wang, Rui-Zhe Yang, Wei Gu, Jian Wang","doi":"10.1002/wjo2.219","DOIUrl":"10.1002/wjo2.219","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the effectiveness of vacuum-assisted closure (VAC) against traditional drainage technique, using a retrospective case-control study design, in terms of managing deep neck infections (DNIs).</p><p><strong>Methods: </strong>Patients presenting to Peking Union Medical College Hospital diagnosed with DNIs were recruited in this study. We analyzed the clinical characteristics of DNI patients and divided them into (a) VAC placement group (26 cases) and (b) traditional drainage group (57 cases) according to whether VAC was placed. The differences in length of stay (LOS), wound healing time, and debridement frequency were compared between the two groups.</p><p><strong>Results: </strong>Eighty-three patients had multiple-space infections, i.e. infection at two or more sites. The debridement frequency of the VAC group was significantly lower than that of the traditional drainage group (<i>p</i> = 0.001). The wound healing time of the traditional drainage group and VAC group was 38 days (a range of 13-98 days) and 40 days (a range of 11-106 days), respectively; the average LOS was 15 days (a range of 2-68 days) and 16 days (a range of 4-35 days), respectively; and the debridement frequencies were one time (a range of 0-3 times) and zero times (a range of 0-2 times), respectively. The two groups did not differ significantly in wound healing time and hospitalization duration (<i>p</i> = 0.319 and 0.937).</p><p><strong>Conclusions: </strong>VAC treatment of DNIs has significant advantages in reducing the frequency of debridement and patient suffering, but it does not show significant advantages in wound healing. Randomized trials are still needed to demonstrate its efficacy.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":"11 3","pages":"425-432"},"PeriodicalIF":1.4,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of and outcomes related to perioperative myocardial injury post-tracheotomy.","authors":"Randy W Lesh, Jino Park, Vincent M Desiato, Martin Matsumura, Thorsen W Haugen","doi":"10.1002/wjo2.218","DOIUrl":"10.1002/wjo2.218","url":null,"abstract":"<p><strong>Introduction: </strong>Perioperative myocardial injury (PMI) is associated with increased mortality. We describe risk factors for and outcomes of PMI in patients undergoing tracheotomy.</p><p><strong>Methods: </strong>Retrospective study of patients undergoing tracheotomy from 2007 to 2016. PMI was defined by a postoperative cardiac troponin I (cTnI) > 99th percentile. Demographics and comorbidities were extracted from the electronic medical record and compared between patients with and without PMI. Significant univariate predictors were included in a multivariable logistic regression model to determine independent predictors of PMI. Thirty-day and 1-year mortality of patients with and without PMI were compared.</p><p><strong>Results: </strong>Of 861 patients undergoing tracheotomy, 41 (4.76%) had PMI and 820 (95.24%) did not. PMI was associated with higher mortality at both 30 days (40.5% vs. 11.2%, <i>p</i> < 0.001) and 1 year (73.2% vs. 44.1%, <i>p</i> < 0.001). Patients with PMI were older (median age 65 vs. 60, <i>p</i> = 0.002) and more likely to have prior myocardial infarction (MI) (36.6% vs. 10.7%, <i>p</i> < 0.001) and chronic kidney disease (31.7% vs. 16.7%, <i>p</i> = 0.024). Cancer diagnosis was associated with a lower risk of PMI (24.4% vs. 41.8%, <i>p</i> = 0.041). Older age (odds ratio [OR] = 1.033, <i>p</i> < 0.001) and prior MI (OR = 3.686, <i>p</i> < 0.001) were independently associated with PMI.</p><p><strong>Conclusion: </strong>Patients with PMI following tracheotomy had increased short- and long-term mortality. Increased age and history of prior MI were independent predictors of PMI, while cancer was associated with a lower risk of PMI following tracheotomy. ICU patients likely have more acute ailments contributing to a higher risk of PMI and poorer outcomes compared to cancer patients requiring tracheotomy. We propose routine screening for PMI with cTnI in the postoperative period in all tracheotomy patients.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":"11 3","pages":"412-416"},"PeriodicalIF":1.4,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The characteristics of sinonasal inverted papilloma and recurrence factors: An analysis of 207 cases.","authors":"SeyedHadi SamimiArdestani, Mojtaba Mohammadi Ardehali, Shirin Irani, Mohammadreza Firouzifar, Mohammad Ali Kazemi, Farzad Yazdani, Maryam Lotfi, Mir Mohammad Jalali, Maliheh Akbarpour","doi":"10.1002/wjo2.216","DOIUrl":"10.1002/wjo2.216","url":null,"abstract":"<p><strong>Objectives: </strong>Sinonasal inverted papilloma (IP) is a rare and benign tumor that affects the nose and sinuses. This tumor has a recurring nature and can be associated with malignancy or transform into a malignant lesion. Various factors have been proposed as potential recurrent and malignancy risk factors in sinonasal IP. This study examines some of these factors and the relationship between tumor location and recurrence and malignancy.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on patients diagnosed with IP for 10 years or more, assessing the patients' demographic statistics and intraoperative observations. Additionally, CT scan results of the patients were investigated.</p><p><strong>Results: </strong>Finally, 207 patients with an average age of (52.0 ± 13.8) years were included in the study. A hundred and fifty-five (74.9%) of patients were male and the most substance abuse was tobacco (72, 34.8%). Fifty-five (26.6%) patients had a recurrence and 21 (10.2%) patients showed malignancy or dysplastic changes. The most common site of the tumor was the maxillary sinus (131, 63.3%).</p><p><strong>Conclusions: </strong>Long-term follow-up of IP patients is necessary due to the risk of recurrence and malignancy. The probability of recurrence was higher in cases where the tumor involved the frontal sinus or multisite attachment. Therefore, for accurate diagnosis of this tumor and complete resection of the lesion, especially in cases where achieving a free margin may be challenging, the intraoperative frozen section seems necessary.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":"11 3","pages":"385-390"},"PeriodicalIF":1.4,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Noise and the risk of tinnitus: A two-sample Mendelian randomized study.","authors":"He-Sen Huang, Kai-Qin Chen, Wen-Kao Zhou, Bin Zhang, Jing Gao, Fei Xie, Yu Du","doi":"10.1002/wjo2.211","DOIUrl":"10.1002/wjo2.211","url":null,"abstract":"<p><strong>Objectives: </strong>Observational studies imply that noise may increase the likelihood of developing tinnitus. However, no causal relationship has been established between the two using Mendelian randomization (MR) analysis, we aimed to determine the potential causal relationship between noise and various categories of tinnitus.</p><p><strong>Methods: </strong>We extracted single nucleotide polymorphisms (SNPs) associated with noise and tinnitus from a large genome-wide association study (GWAS) of European individuals. UK Biobank (UKB) provided summary data for both entities. Inverse variance weighting (IVW) was implemented as the primary method for evaluating effect estimates. Using Weighted median and MR-Egger regression, heterogeneity and pleiotropy were evaluated using sensitivity analyses.</p><p><strong>Results: </strong>The random-effects IVW approach revealed a causal relationship between noise and the three onset tinnitus (odds ratio [OR] = 1.052, 95% confidence interval [CI] = 1.013-1.092, <i>p</i> = 0.008; OR = 1.248, 95% CI = 1.177-1.323, <i>p</i> = 0.001; OR = 1.133, 95% CI = 1.058-1.213, <i>p</i> = 0.001). Noise was not a risk factor for tinnitus in the past (OR = 0.999, 95% CI = 0.934-1.068, <i>p</i> = 0.969). Validation with various Mendelian randomization methodologies and sensitivity analyses confirmed the findings' consistency.</p><p><strong>Conclusion: </strong>This Mendelian Randomization study provides causal evidence that noise is a risk factor for the onset of tinnitus but is not a risk factor for developing tinnitus in the past.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":"11 2","pages":"189-197"},"PeriodicalIF":0.0,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12172121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bedside intubation of a child with a difficult airway-The otolaryngologist perspective.","authors":"Inbal Hazkani, Matthew J Rowland, Maeve A Serino, Ashley Young, Taher Valika, Saied Ghadersohi, Jonathan B Ida","doi":"10.1002/wjo2.217","DOIUrl":"10.1002/wjo2.217","url":null,"abstract":"<p><strong>Objectives: </strong>Children with a difficult airway are prone to severe complications in unplanned intubation events. The otolaryngologist is often required to secure the airway using advanced techniques once the traditional methods have failed to establish safe tracheal intubation. The goal of our study was to describe the otolaryngologist's experience in the management of bedside difficult pediatric airway events.</p><p><strong>Methods: </strong>A case series with chart review of children intubated by the difficult airway response (RaDAR) team in an academic tertiary-care children's hospital. The electronic medical charts of patients intubated by the RaDAR team between Jan 2020 and Dec 2021 were reviewed. The steps taken to recognize and signal patients with a difficult airway are described.</p><p><strong>Results: </strong>Of the 78 airway code events managed by the RaDAR team, 28 (37.2%) were intubated by an otolaryngologist. Of these, 20 (71.4%) were recognized and signaled as a \"difficult airway\" before emergent intubation. The methods to secure the airway were direct laryngoscopy (<i>n</i> = 7), flexible bronchoscopy with/without a laryngeal mask (<i>n</i> = 10), rigid bronchoscopy (<i>n</i> = 8), and video laryngoscopy (<i>n</i> = 1). On average, there were 1.93 attempts to secure the airway following RaDAR activation. The airway was secured by an otolaryngology trainee in 24/28 patients. None of the patients required bedside tracheostomy.</p><p><strong>Conclusions: </strong>Otolaryngologists have unique skills and instruments that may assist with the management of a child with a difficult airway. Close collaboration with anesthesia colleagues, proper training, and proactive recognition and signaling of patients at risk for difficult airway are key factors for safe airway securement.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":"11 3","pages":"417-424"},"PeriodicalIF":1.4,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel application of bone marrow mesenchymal stem cells combined with hepatocyte growth factor on subacute vocal fold wound healing.","authors":"En-Hong Xu, Xin-Jun Meng, Tian-Yu Wang, Shun-Yu Wu, Huan-Hai Liu, Jun-Tian Lang","doi":"10.1002/wjo2.215","DOIUrl":"10.1002/wjo2.215","url":null,"abstract":"<p><strong>Objectives: </strong>Vocal fold (VF) scar causes solemn vocal problems for patients with previous surgery or laryngeal injury. It is also a difficult management problem for clinicians since rare superior management methods are available at present. Previous research usually focuses on the acute period of VF wound repairing, with little attention on subacute period intervention. Bone marrow mesenchymal stem cells (BMMSCs) and hepatocyte growth factor (HGF) combinations that are applied to treat VF wounds are rarely reported. The current study investigated the effects of BMMSCs-HGF application on the regeneration of the VF mucosa during the subacute period.</p><p><strong>Methods: </strong>A bilateral wound was generated by forceps in the VF of each New Zealand White rabbit. BMMSCs are based on the acellular dermal matrix as cell carriers. Various compounds (BMMSCs-AMD complex with or without HGF) was injected into the wounded VF at 2- or 4-weeks following injury. Animals were killed at 60 days postinjection. Imaging of excised larynges was performed with the transmission electron microscope (TEM), and Immunohistochemical (IHC) analysis was also conducted.</p><p><strong>Results: </strong>Collectively, 18 rabbits accepted injury modeling, with two of them died before repairing intervention. IHC results indicated that type-I collagen was significantly devalued in the cluster injected with BMMSCs-HGF than simple application of BMMSCs. The results of TEM suggested that the BMMSCs-HGF injection can significantly reduce the collagen score.</p><p><strong>Conclusion: </strong>Our preliminary study suggests opening regenerative effects of intervention for VF subacute scaring, with BMMSCs-HGF.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":"11 2","pages":"264-275"},"PeriodicalIF":0.0,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12172131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance and reliability evaluation of an improved machine learning-based pure-tone audiometry with automated masking.","authors":"Nicolas Wallaert, Antoine Perry, Sandra Quarino, Hadrien Jean, Gwenaelle Creff, Benoit Godey, Nihaad Paraouty","doi":"10.1002/wjo2.208","DOIUrl":"10.1002/wjo2.208","url":null,"abstract":"<p><strong>Objective: </strong>Automated air-conduction pure-tone audiograms through Bayesian estimation and machine learning (ML) classification have recently been proposed in the literature. Although such ML-based audiometry approaches represent a significant addition to the field, they remain unsuited for daily clinical settings, in particular for listeners with asymmetric or conductive hearing loss, severe hearing loss, or cochlear dead zones. The goal here is to expand on previously proposed ML approaches and assess the performance of this improved ML audiometry for a large sample of listeners with a wide range of hearing status.</p><p><strong>Methods: </strong>First, we describe the changes made to the ML method through the addition of: (1) safety limits to test listeners with a wide range of hearing status, (2) transient responses to cater for cochlear dead zones or nonmeasurable thresholds, and importantly, (3) automated contralateral masking to test listeners with asymmetric or conductive hearing loss. Next, we compared the performance of this improved ML audiometry with conventional and manual audiometry in a large cohort (<i>n</i> = 109 subjects) of both normal-hearing and hearing-impaired listeners.</p><p><strong>Results: </strong>Our results showed that for all audiometric frequencies tested, no significant difference was found between hearing thresholds obtained using manual audiometry on a clinical audiometer as compared to both the manual and automated improved ML methods. Furthermore, the test-retest difference was not significant with the automated improved ML method for each audiometric frequency tested. Finally, when examining cross-clinic reliability measures, significant differences were found for most audiometric frequencies tested.</p><p><strong>Conclusions: </strong>Together, our results validate the use of this improved ML-based method in adult clinical tests for air-conduction audiometry.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":"11 2","pages":"173-188"},"PeriodicalIF":0.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12172120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of laryngeal reinnervation compared to medialization thyroplasty in the treatment of unilateral vocal fold paralysis: A systematic review and network meta-analysis.","authors":"Muhnnad A AlGhamdi, Lama Nasser Alghamdi, Mohamed Khalid AlQazenli, Dhay Saleh Alrashid, Zainab Bakhsh","doi":"10.1002/wjo2.214","DOIUrl":"10.1002/wjo2.214","url":null,"abstract":"<p><strong>Introduction: </strong>Unilateral vocal fold paralysis (ULVP) is characterized by the complete immobility of a single vocal fold which can cause significant health challenges, including voice impairment, difficulty swallowing, and a high risk of aspiration due to glottic incompetency. The aim of this study is to systematically review the effectiveness of laryngeal reinnervation (LR) and medialization thyroplasty (MT) in the treatment of ULVP.</p><p><strong>Materials and methods: </strong>Medline, PubMed, Cochrane Library, OVID, Scopus, Springer Nature Journals, ScienceDirect, and Directory of Open Access Journals databases were searched. Restriction to non-English studies were applied. Studies were excluded if subjects had previous treatment for ULVP, if they had co-existing neuromuscular disease affecting the larynx, and if they had significant non-laryngeal speech abnormalities.</p><p><strong>Results: </strong>Fifteen articles were reviewed, all conducted between 2003 and 2023. Among the 864 participants included, 48 underwent LR, 348 underwent MT, and the remaining 432 were in the comparison group, which involved injection laryngoplasty (IL), voice therapy (VT), placebo, and medialization with arytenoid adduction. Meta-analyses compared LR to MT and MT to alternative treatments, revealing a preference for MT. The comparison between LR and MT in the network meta-analysis yielded a mean difference of 0.33 (95% CI: -11.79, 12.6) favoring the MT group, ranking using SUCRA values highlighted that MT is the best treatment modality followed by LR.</p><p><strong>Discussion: </strong>The results of the network meta-analysis and the subgroup meta-analysis showed that MT is better than alternative treatments that were included in this study. Moreover, management modalities should be individualized to each patient as many factors are important and may affect the final outcomes.</p><p><strong>Conclusions: </strong>While the network meta-analysis indicates that MT may be more effective than alternative treatments for managing ULVP, the results should be interpreted with caution due to potential confounding factors. One notable limitation is the small sample size in the LR group. Despite these limitations, the findings contribute to the existing literature and can help guide future research on optimal interventions for the treatment of ULVP.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":"11 3","pages":"449-461"},"PeriodicalIF":1.4,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}