Dimin Zhou1, Mohsin Jafri2, Inna Husain3. 1. 1 Chicago Medical School, Rosalind Franklin University, North Chicago, Illinois, USA. 2. 2 Northwestern University, Evanston, Illinois, USA. 3. 3 Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, USA.
Abstract
OBJECTIVE: To identify dysphagia prevalence and characteristics among patients with unilateral vocal fold immobility (UVFI) through a systematic review of current literature. DATA SOURCES: Embase, PubMed, ScienceDirect, Wiley Online Library. REVIEW METHODS: Four electronic databases were reviewed according to the PRISMA criteria. Original English-language studies examining dysphagia among adult patients with UVFI met eligibility. Two researchers independently analyzed qualified articles. RESULTS: Of 227 studies discovered through the literature search, 17 satisfied eligibility criteria. The prevalence of symptomatic dysphagia ranged from 55.6% to 69.0%, and the aspiration rate was 20.0% to 50.0%. Self-reporting and clinical evaluation were used to identify symptomatic dysphagia, while videofluoroscopic swallowing study and functional endoscopic evaluation of swallowing evaluated aspiration. Left-sided UVFI predominated. The most common causes of UVFI were iatrogenic and idiopathic. Central lesions and acute-onset UVFI were each associated with more severe dysphagia. Patients were more likely to aspirate on liquids versus purées and pastes. Benefits of medialization thyroplasty and vocal cord injection were equivocal. CONCLUSION: A significant portion of patients with UVFI present with dysphagia due to anatomic and physiologic disruptions during the swallow. Study population heterogeneity and small sample sizes in the reviewed studies may have compromised reliability, calling for large-scale studies with rigorous methodology. Future studies should not only strive to identify the mechanics of the disordered swallow but also explore patients' quality of life and the effectiveness of current treatments for dysphagia with underlying UVFI.
OBJECTIVE: To identify dysphagia prevalence and characteristics among patients with unilateral vocal fold immobility (UVFI) through a systematic review of current literature. DATA SOURCES: Embase, PubMed, ScienceDirect, Wiley Online Library. REVIEW METHODS: Four electronic databases were reviewed according to the PRISMA criteria. Original English-language studies examining dysphagia among adult patients with UVFI met eligibility. Two researchers independently analyzed qualified articles. RESULTS: Of 227 studies discovered through the literature search, 17 satisfied eligibility criteria. The prevalence of symptomatic dysphagia ranged from 55.6% to 69.0%, and the aspiration rate was 20.0% to 50.0%. Self-reporting and clinical evaluation were used to identify symptomatic dysphagia, while videofluoroscopic swallowing study and functional endoscopic evaluation of swallowing evaluated aspiration. Left-sided UVFI predominated. The most common causes of UVFI were iatrogenic and idiopathic. Central lesions and acute-onset UVFI were each associated with more severe dysphagia. Patients were more likely to aspirate on liquids versus purées and pastes. Benefits of medialization thyroplasty and vocal cord injection were equivocal. CONCLUSION: A significant portion of patients with UVFI present with dysphagia due to anatomic and physiologic disruptions during the swallow. Study population heterogeneity and small sample sizes in the reviewed studies may have compromised reliability, calling for large-scale studies with rigorous methodology. Future studies should not only strive to identify the mechanics of the disordered swallow but also explore patients' quality of life and the effectiveness of current treatments for dysphagia with underlying UVFI.