Early-injection laryngoplasty may lower risk of thyroplasty: A systematic review and meta-analysis

Peter M. Vila, Neel K. Bhatt, Randal C. Paniello

Research output: Contribution to journalReview articlepeer-review

31 Scopus citations


Objective: To determine whether injection laryngoplasty within 6 months following the onset of unilateral vocal fold paralysis (UVFP) decreases the rate of permanent thyroplasty in adults. Data Sources: Search strategies created by a medical librarian were implemented in multiple online research databases. Review Methods: Inclusion and exclusion criteria were designed to capture randomized clinical trials and cohort studies examining adults with UVFP who received injection laryngoplasty early in the course of treatment, within 6 months of onset, or who were observed. The primary outcome was the rate of thyroplasty. The Newcastle-Ottawa scale was used to assess quality of included cohort studies. Random effects meta-analysis was used to calculate an overall relative risk (RR). Heterogeneity was evaluated with the I2 statistic. Results: The search strategy resulted in 1,177 studies, of which four cohort studies remained for meta-analysis after applying inclusion and exclusion criteria. All studies were rated as 9 of 9 on the Newcastle-Ottawa scale. Meta-analysis of 275 patients with UVFP revealed that the overall pooled RR of undergoing thyroplasty in those receiving an early injection was 0.25 (95% confidence interval 0.14–0.45) compared to conservative management (late or no injection). The I2 overall was 62.4%. Conclusion: Otolaryngologists should offer injection laryngoplasty to patients with a diagnosis of UVFP within 6 months of diagnosis (recommendation based on grade C evidence with a preponderance of benefit over harm). Laryngoscope, 128:935–940, 2018.

Original languageEnglish
Pages (from-to)935-940
Number of pages6
Issue number4
StatePublished - Apr 2018


  • Paralysis
  • adult
  • laryngoplasty
  • meta-analysis
  • treatment outcome
  • unilateral
  • vocal cord
  • vocal fold


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