• Taner Yılmaz, Nilda Süslü, Gamze Atay, Serdar Özer, Rıza Önder Günaydın, and Münir Demir Bajin.
• Department of Otolaryngology, Head & Neck Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey. tyilmaz@hacettepe.edu.tr
• JAMA Otolaryngol Head Neck Surg. 2013 Jul 1; 139 (7): 712-8.

ImportanceTotal arytenoidectomy is claimed to increase risk of aspiration and cause more voice loss than other operations performed for bilateral abductor vocal fold paralysis (BVFP). However, objective evidence for such a conclusion is lacking. There is no study comparing swallowing and voice after total and partial arytenoidectomy.ObjectiveTo compare voice and swallowing parameters after endoscopic total and partial arytenoidectomy for BVFP.Design, Setting, And ParticipantsIn this prospective, randomized, double-blind, case-control study conducted at a tertiary referral university, the study population comprised 20 patients with BVFP.InterventionsEndoscopic total and partial arytenoidectomy.Main Outcomes And MeasuresDecannulation, duration of operation, Voice Handicap Index, acoustic and aerodynamic analysis, postoperative breathing ability, subjective comparison of preoperative and postoperative voice, speech intensity, and functional outcome swallowing scale.ResultsMedian duration of partial and total arytenoidectomies were 59 and 49 minutes, respectively. This difference was statistically significant (P = .04). Comparisons of preoperative and postoperative Voice Handicap Index, acoustic and aerodynamic measures, postoperative breathing ability, subjective comparison of preoperative and postoperative voice, speech intensity, and functional outcome swallowing scale were not statistically significantly different between both groups.Conclusions And RelevanceEndoscopic total and partial arytenoidectomy are very successful static surgical options for BVFP. Partial takes longer than total arytenoidectomy. They both provide a comfortable airway, acceptable voice, and acceptable deglutition. It may be a sound practice to perform partial arytenoidectomy initially for primary BVFP cases and reserve total arytenoidectomy for revision cases.Trial Registrationclinicaltrials.gov Identifier: NCT01824849.

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