| Affiliation: | 1. Universidade Estadual Paulista (Unesp), Faculdade de Medicina de Botucatu, Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Botucatu, SP, Brazil;2. Universidade Estadual Paulista (Unesp), Faculdade de Medicina de Botucatu, Departamento de Cirurgia, Botucatu, SP, Brazil;3. Universidade de São Paulo (USP), Departamento de Otorrinolaringologia, São Paulo, SP, Brazil |
| Abstract: | IntroductionLaryngeal granulomas post intubation are benign but recurrent lesions. There is no consensus for its treatment.ObjectiveTo describe the effectiveness of different treatment modalities for primary or recurrent laryngeal granulomas resulting from endotracheal intubation.MethodsSystematic review and proportional meta-analysis. Eligibility criteria – experimental or observational studies with at least five subjects. Outcomes studied – granuloma resolution, recurrence, and time for resolution. Databases used – Pubmed, Embase, Lilacs, and Cochrane. The Stats Direct 3.0.121 program was used.ResultsSix studies were selected, with 85 patients. The treatments registered were: antireflux therapy, speech therapy, anti-inflammatory drugs, steroids, antibiotics, zinc sulfate and surgery. 85 patients from six studies had primary treatment: surgery ± associations (41 patients), resolution chance 75% (95% CI: 0.3–100%, I2 = 90%), absolute relapse risk 25% (95% CI: 0.2–71%); medical treatment (44 patients), resolution chance 86% (95% CI: 67–97%); and absolute relapse risk 14% (95% CI: 3–33%). There was no significant difference between groups. Three studies, encompassing 19 patients, analyzed secondary treatment (failure or recurrence after primary treatment); three subjects presented new recurrence. The time needed to resolve the lesions varied from immediate, after surgery, to 23 months, for inhaled steroid.ConclusionThere is no evidence of high quality that proves the efficacy of any treatment for laryngeal granulomas resulting from endotracheal intubation. |
