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. 2025 Jan 7;10(1):e70063.
doi: 10.1002/lio2.70063. eCollection 2025 Feb.

The effect of unilateral endoscopic arytenoid abduction lateropexy on swallowing in cases of bilateral vocal fold palsy

Andrea Ambrus  1 , László Rovó  1 , Ádám Bach  1
Affiliations

The effect of unilateral endoscopic arytenoid abduction lateropexy on swallowing in cases of bilateral vocal fold palsy

Andrea Ambrus et al. Laryngoscope Investig Otolaryngol. .

Abstract

Objective: Endoscopic arytenoid abduction lateropexy (EAAL) is a minimally invasive surgical technique for the immediate management of bilateral vocal fold palsy (BVFP). Specifically, it achieves a stable and adequate airway by lateralizing the arytenoid cartilage without resecting laryngeal structures. Thus, this study evaluated the effect of EAAL on swallowing in cases of BVFP.

Methods: The participants consisted of 17 adult patients (15 female, 2 male) who underwent unilateral EAAL for BVFP. Swallowing function was evaluated by using the fiberoptic endoscopic evaluation of swallowing (FEES) on the 6th postoperative day and in the 6th postoperative month. The results were assessed by using the pharyngeal residue severity scale (PRSS) and the modified penetration-aspiration scale (mPAS). Additionally, the M.D. Anderson Dysphagia Inventory (MDADI) questionnaire was self-administered during the 6th postoperative month.

Results: Overall, 16 of the 17 patients demonstrated normal swallowing function during the early and late postoperative periods. Moreover, one patient experienced mild fluid aspiration early on, but initially managed it with dietary adjustments and eventually resolved it with a head flexion compensatory maneuver. There was no significant deterioration in swallowing-related quality of life according to the MDADI assessments.

Conclusion: Based on this evaluation of unilateral EAAL, our results confirmed that this procedure is not only a reliable solution for BVFP from the perspective of respiratory function and phonation but also in terms of swallowing quality.

Level of evidence: 4.

Keywords: bilateral vocal fold palsy; dysphagia; endoscopic arytenoid abduction lateropexy; fiberoptic endoscopic evaluation of swallowing.

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Conflict of interest statement

The endolaryngeal thread guide instrument was patented in Hungary in 2008 (Patent No. U 0700163). László Rovó has intellectual property rights pertaining to this device.

Figures

FIGURE 1
FIGURE 1
Bilateral vocal fold palsy treated with unilateral endoscopic arytenoid abduction lateropexy (EAAL) (Patient #15, endoscopic pictures). (A) Vocal folds in paramedian position. (B) Adequate airway after left‐sided EAAL (6th postoperative month). (C) Minimally coated mucosa in the right pyriform sinus and epiglottic vallecula (6th postoperative month).
See this image and copyright information in PMC

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