110: Pediatric Vocal Cord Paralysis Secondary to Arnold Chiari Malformation: A Systematic Review of Outcome of Surgical Management
Bibliographic record
Abstract
Vocal cord paralysis is known to be associated with Arnold Chiari malformation (ACM). Bilateral vocal cord (VC) paralysis has been reported to account for 30% to 60% of pediatric VC paralyses. Surgical management of ACM often leads to resolution of the VC paralysis. The aim of this review was to evaluate the effect of primary surgical management of ACM on VC paralysis. A comprehensive search was carried out on electronic databases of Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily and Ovid OLDMEDLINE, Embase, and Cochrane Library. Articles published between 1946 and July 2013 were retrieved. Search terms included medical subject subheadings and free text words with Arnold Chiari, ac, Chiari malformation, vocal cord paralysis, and vocal folds. Eligibility criteria included studies in the pediatric population where patients had clinical and radiological diagnosis of ACM; clinical diagnosis of VC paralysis had to be confirmed with laryngoscopy. Eligible articles also had to include the surgical management carried out and the VC outcome after the management. Eighteen articles fulfilled inclusion criteria, for a total of 31 patients. Fifty-eight percent of patients were males. All patients received surgical interventions, which included surgical decompression, shunt operation or a combination of shunt operation and decompression. 67.7% showed full recovery of their VC paralysis. Partial resolution occurred in 22.6% of patients, while 9.7% showed no improvement at all. Complete recovery of VC function occurred either immediately postoperatively or up to several weeks after surgery and was sustained long-term. Vocal cord paralysis associated with ACM resolved fully or partially in over 90% of patients following neurosurgical decompression without a need for further laryngeal surgery. This was noticed long-term.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.021 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.008 | 0.005 |
| Bibliometrics | 0.011 | 0.013 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".