Abstract：
OBJECTIVE: This scoping review aims to comprehensively assess current surgical interventions for bilateral vocal fold paralysis (BVFP), addressing the heterogeneity in treatment outcomes. Additionally, it explores the potential role of soft robotics as an innovative approach to improve outcomes in BVFP management.
METHODS: This scoping review systematically examines literature from MEDLINE, Embase, and Scopus databases. Inclusion criteria encompass studies related to BVFP management with measurable subjective or objective outcomes. Studies with populations solely under the age of 18 were excluded. Four reviewers independently screened 2263 studies, resulting in the selection of 125 papers for data extraction. Information included study characteristics, interventions, and outcomes. Data synthesis involved both quantitative and qualitative analyses.
RESULTS: The review identified 145 surgical interventions grouped into seven types: tracheostomy, cordectomy, arytenoidectomy, lateralization, combined procedures and others. Outcome measures fit into the following categories: \"objective voice,\" \"subjective voice,\" \"aerodynamics,\" \"dyspnea,\" \"decannulation,\" \"swallow,\" and \"quality of life.\" Positive outcomes were predominant across all interventions, with arytenoidectomy and cordectomy showing relatively lower rates of successful objective and subjective voice outcomes. This could be the result of prioritizing improved airway status. Soft robotics is hypothesized as a potential solution to the limitation of current interventions sacrificing voice for breathing.
CONCLUSIONS: The main aim of current surgical interventions for BVFP is expanding glottic aperture. Yet achieving optimal outcomes remains elusive due to complex airflow dynamics and potential impacts on phonatory function and swallowing. The current review underscores the need for a more nuanced, personalized approach, considering individual anatomical and physiological variations. Soft robotics emerges as a promising avenue to address this variability. However, challenges such as implantation procedures, long-term care, and patient education require careful consideration. Collaboration between medical professionals, engineers, and robotics specialists is essential for translating these principles into practical solutions.
METHODS: This scoping review systematically examines literature from MEDLINE, Embase, and Scopus databases. Inclusion criteria encompass studies related to BVFP management with measurable subjective or objective outcomes. Studies with populations solely under the age of 18 were excluded. Four reviewers independently screened 2263 studies, resulting in the selection of 125 papers for data extraction. Information included study characteristics, interventions, and outcomes. Data synthesis involved both quantitative and qualitative analyses.
RESULTS: The review identified 145 surgical interventions grouped into seven types: tracheostomy, cordectomy, arytenoidectomy, lateralization, combined procedures and others. Outcome measures fit into the following categories: \"objective voice,\" \"subjective voice,\" \"aerodynamics,\" \"dyspnea,\" \"decannulation,\" \"swallow,\" and \"quality of life.\" Positive outcomes were predominant across all interventions, with arytenoidectomy and cordectomy showing relatively lower rates of successful objective and subjective voice outcomes. This could be the result of prioritizing improved airway status. Soft robotics is hypothesized as a potential solution to the limitation of current interventions sacrificing voice for breathing.
CONCLUSIONS: The main aim of current surgical interventions for BVFP is expanding glottic aperture. Yet achieving optimal outcomes remains elusive due to complex airflow dynamics and potential impacts on phonatory function and swallowing. The current review underscores the need for a more nuanced, personalized approach, considering individual anatomical and physiological variations. Soft robotics emerges as a promising avenue to address this variability. However, challenges such as implantation procedures, long-term care, and patient education require careful consideration. Collaboration between medical professionals, engineers, and robotics specialists is essential for translating these principles into practical solutions.
摘要：
目的：本范围综述旨在全面评估目前对双侧声带麻痹（BVFP）的手术干预措施，解决治疗结果的异质性。此外,它探讨了软机器人作为改善BVFP管理结果的创新方法的潜在作用。
方法：本范围综述系统地研究了MEDLINE的文献，Embase,和Scopus数据库。纳入标准包括与具有可衡量的主观或客观结果的BVFP管理相关的研究。仅18岁以下人群的研究被排除在外。四位评审员独立筛选了2263项研究，结果选择了125篇论文进行数据提取。信息包括研究特征，干预措施，和结果。数据综合包括定量分析和定性分析。
结果：该综述确定了145种外科干预措施，分为七种类型：气管造口术，导管切除术,软骨样切除术,偏侧化，联合程序和其他。成果衡量标准分为以下几类：“客观声音，\"\"主观的声音，\"\"空气动力学,“\”呼吸困难，\"\"拔管,\"\"燕子,“和”生活质量。“积极的结果在所有干预措施中占主导地位，Arytenoids切除术和声带切除术显示相对较低的成功的客观和主观语音结果。这可能是优先考虑改善的气道状态的结果。软机器人被认为是当前干预措施的局限性的潜在解决方案，该措施牺牲了呼吸的声音。
结论：目前BVFP手术干预的主要目的是扩大声门孔径。然而，由于复杂的气流动力学以及对发声功能和吞咽的潜在影响，实现最佳结果仍然难以捉摸。当前的审查强调需要更细微的，个性化的方法，考虑到个体的解剖和生理变化。软机器人技术成为解决这种可变性的有希望的途径。然而,诸如植入程序之类的挑战，长期护理,和病人的教育需要仔细考虑。医疗专业人员之间的合作，工程师,机器人专家对于将这些原则转化为实际解决方案至关重要。
方法：本范围综述系统地研究了MEDLINE的文献，Embase,和Scopus数据库。纳入标准包括与具有可衡量的主观或客观结果的BVFP管理相关的研究。仅18岁以下人群的研究被排除在外。四位评审员独立筛选了2263项研究，结果选择了125篇论文进行数据提取。信息包括研究特征，干预措施，和结果。数据综合包括定量分析和定性分析。
结果：该综述确定了145种外科干预措施，分为七种类型：气管造口术，导管切除术,软骨样切除术,偏侧化，联合程序和其他。成果衡量标准分为以下几类：“客观声音，\"\"主观的声音，\"\"空气动力学,“\”呼吸困难，\"\"拔管,\"\"燕子,“和”生活质量。“积极的结果在所有干预措施中占主导地位，Arytenoids切除术和声带切除术显示相对较低的成功的客观和主观语音结果。这可能是优先考虑改善的气道状态的结果。软机器人被认为是当前干预措施的局限性的潜在解决方案，该措施牺牲了呼吸的声音。
结论：目前BVFP手术干预的主要目的是扩大声门孔径。然而，由于复杂的气流动力学以及对发声功能和吞咽的潜在影响，实现最佳结果仍然难以捉摸。当前的审查强调需要更细微的，个性化的方法，考虑到个体的解剖和生理变化。软机器人技术成为解决这种可变性的有希望的途径。然而,诸如植入程序之类的挑战，长期护理,和病人的教育需要仔细考虑。医疗专业人员之间的合作，工程师,机器人专家对于将这些原则转化为实际解决方案至关重要。
