Vibratory Analysis of the Neoglottis After Surgical Intervention of Cricopharyngeal Myotomy and Implantation of Tracheal Cartilage

Abstract

To review systematically and meta-analyze the results of all randomized controlled trials (RCTs) for the treatment of patients with Bell palsy with corticosteroids vs corticosteroids plus antiviral agents. Data Sources: A MEDLINE, EMBASE, Cochrane Library, and CENTRAL database search, followed by extensive hand-searching for the identification of relevant studies. No time and language limitations were applied. Study Selection: Prospective RCTs on the treatment of patients with Bell palsy. Data Extraction: Odds ratios (ORs), 95% confidence intervals (CIs), and tests for heterogeneity were reported. Data Synthesis: Five studies were eventually identified and systematically reviewed. Meta-analysis was performed for 4 studies. Regarding the complete recovery rate of facial nerve paralysis 3 months after initiation of therapy, the current systematic review and metaanalysis suggests that the addition of an antiviral agent does not provide any benefit (OR, 1.03 [95% CI, 0.74-1.42]; P=.88). The same conclusion emerged at posterior (fourth, sixth, and ninth) months of assessment. Subgroup analysis, conducted on the basis of time point of therapy initiation, type of antiviral agent, and blindness of assessments did not change the results obtained. The occurrence rate of adverse effects attributable to therapy choice was not significantly different between patients receiving corticosteroids and those following combined treatment. Conclusion: The present systematic review and metaanalysis, based on the currently available evidence, suggests that the addition of an antiviral agent to corticosteroids for the treatment of Bell palsy is not associated with an increase in the complete recovery rate of the facial motor function.

Steroids with and Without Antivirals in the Treatment of Bell’s Palsy: Does It Make any Difference in Recovery? A Study at a Tertiary Care Center, Karachi, Pakistan

“…A large meta-analysis was inconsistent with this study, where the addition of acyclovir with prednisolone was not proven beneficial (20). Another recent trial also has in contrast to the present study where investigators did not find any improvement with the addition of antiviral valaciclovir with steroids in Bell's recovery (21). A recent study (22) has shown similar results where the addition of acyclovir to prednisolone has been found to be superior in the treatment of Bell's Palsy where patients had a 76.2% recovery, while prednisolone given alone had a 57.1% recovery.…”

Aerodynamics of the Pseudo-Glottis

“…In addition, the tone of the surrounding muscles bordering the PE junction as well as the postoperative fibrosis may contribute to the increase in the resistance of the pseudo-glottis. This post-operative status varies among laryngectomy patients [23] . All the previously mentioned factors may explain the increased resistance of the pseudo-glottis as compared to the true glottis.…”

Model-based quantification of pathological voice production

“…The high-speed imaging technique is also applicable to the observation of the vibrating PE segment during substitute voice production [8,83,84]. procedure, the tracheostoma is manually closed by the patient for substitute voice production.…”