Journal of voice : official journal of the Voice Foundation · 2024
Glottal Insufficiency and Parkinson's Disease: A Scoping Review of Vocal Fold Medialization Procedures.
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Garabedian Megan, Keltz Andrew, Lerner Michael Z, Brackett Alexandria, Leydon Ciara
Аннотация
OBJECTIVES/HYPOTHESIS: Vocal impairments are early and debilitating symptoms of Parkinson's disease (PD). Glottal insufficiency is a contributor to PD-related dysphonia. Vocal fold injection laryngoplasty (IL) and medialization thyroplasty (MT) are well-established techniques used to restore glottal closure for a range of causes. While use of these interventions to improve vocal function in people with Parkinson's disease (PWPD) has been described in literature, a scoping review of the nature, extent, and duration of benefits of procedural intervention to improve vocal fold closure is warranted to provide insight into patient candidacy for vocal fold medialization procedures in addition to standard PD-specific speech therapy protocols.
STUDY DESIGN: Scoping review.
METHODS: Seven biomedical databases and two gray literature resources were searched to retrieve English-language publications, without restrictions on publication type. Eligibility criteria were diagnosis of participants with PD in adults, presence of a voice concern (eg, dysphonia or glottal insufficiency), and intervention using IL or MT.
RESULTS: The search yielded 174 sources of evidence, 18 of which met inclusionary criteria. In total, 13 publications were research studies, three were reviews, one was a conference proceeding, and one was a book chapter. All available auditory-perceptual, quality of life, acoustic, endoscopic, and safety outcomes were tabulated for case studies and case reports. Studies revealed feasibility, and positive, yet varied, short-term outcomes of IL or MT. The quality of research articles was critically appraised using Joanna Briggs Institute checklists revealing trends of incomplete description of participant demographics, nonconsecutive enrollment of participants, absence of control participants, and lack of validity of several outcome measures.
CONCLUSIONS: Further research, using a rigorous, controlled, blinded, prospective research design to reduce potential bias and improve generalizability of findings is warranted to clarify the benefit of IL and MT, with or without speech therapy, to improve vocal function for PWPD and guide patient selection for vocal fold medialization procedures.
STUDY DESIGN: Scoping review.
METHODS: Seven biomedical databases and two gray literature resources were searched to retrieve English-language publications, without restrictions on publication type. Eligibility criteria were diagnosis of participants with PD in adults, presence of a voice concern (eg, dysphonia or glottal insufficiency), and intervention using IL or MT.
RESULTS: The search yielded 174 sources of evidence, 18 of which met inclusionary criteria. In total, 13 publications were research studies, three were reviews, one was a conference proceeding, and one was a book chapter. All available auditory-perceptual, quality of life, acoustic, endoscopic, and safety outcomes were tabulated for case studies and case reports. Studies revealed feasibility, and positive, yet varied, short-term outcomes of IL or MT. The quality of research articles was critically appraised using Joanna Briggs Institute checklists revealing trends of incomplete description of participant demographics, nonconsecutive enrollment of participants, absence of control participants, and lack of validity of several outcome measures.
CONCLUSIONS: Further research, using a rigorous, controlled, blinded, prospective research design to reduce potential bias and improve generalizability of findings is warranted to clarify the benefit of IL and MT, with or without speech therapy, to improve vocal function for PWPD and guide patient selection for vocal fold medialization procedures.