A Meta-analysis Of Acoustic Prognosis After Unilateral Recurrent Laryngeal Nerve Reconstruction

Objective: Using the meta-analysis to evaluate the effectiveness of unilateral recurrent laryngeal nerve reconstructions in vocal function improvement in patients with recurrent laryngeal nerve injury and explore the difference of prognosis after various reconstructive surgical methods.Methods: Relevant studies were identified by searching Pubmed?Ovid-medline?Web Of Science?EMBASE?Cochrane Library database.The literature was screened in strict accordance with the inclusion criteria,and the relevant data were extracted from the literature.Meta-analysis was performed by Revman 5.3.Results: A total of 17 articles were included in the literature,including 684 patients.(1)For the patients underwent surgery for 6 months,the results of the different parameters were as follows:for MPT,P< 0.0001;I2 = 73%,WMD=8.02;95%CI[6.63,9.41],for Jitter,P = 0.0009;I2 = 71%,WMD =-1.94;95% CI [-2.24,-1.65],for Shimmer,P = 0.02;I2 = 58%,WMD =-1.94;95% CI [-2.24,-1.65],the three statistic results 95% CI less than 0,statistically significant,means the pronunciation function of patients with unilateral recurrent laryngeal nerve injury was significantly improved after neurological reconstruction.(2)According to the different follow-up time after operation,the MPT of >6 months after operation was significantly higher than that of <6 months after operation,P = 0.50;I2 = 0%,WMD = 1.79;95% CI [0.46,3.13],But there was no significant difference between >6 and Shimmer months after operation and <6 months after operation,P = 0.96;I2 = 0%,WMD = 0.37;95% CI [-0.90,1.63].(3)There was no significant difference in Shimmer between different surgical methods: Comparing the Shimmer of AR group and the FNG group,P = 0.93;I2 = 62%,WMD=0.07;95%CI [-1.69,1.84]],Comparing the Shimmer of AR group and the RR group,.P = 0.55;I2 = 71%,WMD=-0.37;95%CI [-1.56,0.83].Conclusion: 1.Recurrent laryngeal nerve reconstruction can significantly improve the the pronunciation function of patients with unilateral recurrent laryngeal nerve injury;2.Pronunciation function can be significantly improved in Unilateral recurrent laryngeal nerve injury patients after 6 months of recurrent laryngeal nerve reconstruction;3.Tthere is no difference in the improvement of the pronunciation function between the patients with different surgical procedures of recurrent laryngeal nerve reconstruction.