Impact of ipsilateral false vocal fold resection on swallowing following transoral laser cordectomies - a pilot study

Our aim was to investigate the early and late impact of false vocal fold removal (vestibulectomy) on swallowing using fibreoptic endoscopic evaluation of swallowing (FEES) following type III, IV and V transoral laser cordectomies (TLC). Fifteen endoscopically resectable glottic cancers necessitating TLC with vestibulectomy were included. FEES was performed preoperatively and in both the early and late postoperative periods establishing modified penetration aspiration scale (mPAS) and pharyngeal residue severity scale (PRSS). Laryngeal preservation and local recurrence were also noted. Due to 10 T1a, 2 T1b, 2 T2 and 1 selected T3 diseases, 2 type III, 9 type IV, 2 type Va and 2 type Vd cordectomies were performed. Early and late average postoperative PRSS scores were 1 and 0, respectively, while early and late postoperative mPAS scores were identically 1. Neither early nor late postoperative PRSS and mPAS values (0 and 1, respectively) differed remarkably from preoperative scores. Laryngeal preservation failed in only one case due to recurrence. TLC provides excellent laryngeal preservation in early glottic cancer. In our series, ipsilateral vestibulectomy during TLC did not deteriorate swallowing neither by increased pharyngeal residue nor by increased aspiration risk. Nevertheless, a higher case number is recommended to statistically confirm our observations.