Office-Based Laser Therapy in Vocal Fold Polyps: A Systematic Review and Meta-Analysis

Christophe Abi Zeid Daou; Anthony Ghanem; Jad Hosri; Patrick Abou Raji Feghali; Abdul-Latif Hamdan

doi:10.1016/j.jvoice.2023.03.003

Office-Based Laser Therapy in Vocal Fold Polyps: A Systematic Review and Meta-Analysis

J Voice. 2023 Mar 30:S0892-1997(23)00095-4. doi: 10.1016/j.jvoice.2023.03.003. Online ahead of print.

Authors

Christophe Abi Zeid Daou¹, Anthony Ghanem², Jad Hosri¹, Patrick Abou Raji Feghali¹, Abdul-Latif Hamdan³

Affiliations

¹ Department of Otolaryngology and Head & Neck Surgery, American University of Beirut-Medical Center, Beirut, Lebanon.
² Department of Otolaryngology and Head & Neck Surgery, American University of Beirut-Medical Center, Beirut, Lebanon. Electronic address: anthonyghanem01@gmail.com.
³ Department of Otolaryngology and Head & Neck Surgery, American University of Beirut-Medical Center, Beirut, Lebanon. Electronic address: ah77@aub.edu.lb.

PMID: 37003865
DOI: 10.1016/j.jvoice.2023.03.003

Abstract

Objectives: To analyze voice outcomes and lesion regression in patients with vocal fold polyps treated in-office using lasers.

Study design: Systematic review and meta-analysis.

Methods: The search was performed in the Medline, Embase, and Cochrane databases using the preferred reporting items for systematic review and meta-analyses framework. There were no limitations to the year of publication and the search included studies looking at voice outcomes and lesion evolution of in-office laser treatment for vocal fold polyps measured through voice-handicap index, GRB, acoustic analysis or aerodynamics measures. Risk of bias was assessed using Cochrane's ROBINS-I tool for observational studies. Data analysis was performed SPSS software with a significance level of 5%.

Results: We identified 167 articles, 10 of which met the inclusion criteria and were analyzed. The total number of participants was 242. Meta-analysis showed significant improvement in voice handicap index-10 scores (95% CI, [0.86; 1.45]) and decrease in GRB score (95% CI, [1.09; 4.13]) after in-office laser therapy. It also showed significant improvement in percent shimmer (95% CI, [0.26; 1.01]), and significant increase in maximum phonation time (95% CI, [-0.92; -0.18]).

Conclusions: Laser therapy an outpatient office setting is a reliable alternative to classical phono-microsurgery. Results show Office-based laser therapy of vocal fold polyps results in a significant improvement in subjective voice outcomes measures. This subjective improvement in voice quality is associated with partial or complete disease regression on laryngeal examination and an increase in maximum phonation time. Ovlaryngeal examination in patients with polyps treated with in-office laser.

Keywords: Voice—Laryngology—Vocal fold polyps—Lasers—Meta-analysis.

Publication types

Review