{Reference Type}: Journal Article
{Title}: Management Options for Bilateral Vocal Fold Impairment: Scoping Review to Assess the Potential of Soft Robotics Solutions.
{Author}: Mathew A;Rama E;Kang K;Williams K;Birchall M;Iliadou E;
{Journal}: J Voice
{Volume}: 0
{Issue}: 0
{Year}: 2024 Jun 6
{Factor}: 2.3
{DOI}: 10.1016/j.jvoice.2024.04.031
{Abstract}: <B>OBJECTIVE: </B>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.<BR><B>METHODS: </B>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.<BR><B>RESULTS: </B>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.<BR><B>CONCLUSIONS: </B>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.