Arytenoid adduction asymmetry among patients with laryngeal disorders

Abstract

Arytenoid asymmetry is usually an incidental finding during video-pharyngo-laryngoscopic examinations, and few otolaryngologists have described the clinical implications of this among patient with laryngeal disorders. The aim of the study is to document the prevalence of arytenoid adduction asymmetry in patients who had video-pharyngo-laryngoscopy and determine if there is any possible association between arytenoid adduction asymmetry and hoarseness. This is a retrospective descriptive study involving patients who had video-pharyngo-laryngoscopic examinations for various indications. The medical charts and video-pharyngo-laryngoscopic examination findings recorded in the stored database in ENT outpatient departments of two institutions over a 2-year period were retrospectively reviewed for age, sex, occupation, presenting complaint, and indication for video-pharyngo-laryngoscopic findings and diagnosis. Arytenoid adduction asymmetry was defined in relation to the position of the corniculate cartilages, cuneiform cartilages, and aryepiglottic angle. All the variables in the data were analyzed using Statistical Product and Service Solution (SPSS) version 25. A total of 152 out of 209 patients had complete information needed for the review, 59 were males and 93 females with age range 20–91 years, and mean age was 46 ± 15.5 years. The overall prevalence rate for adduction asymmetry was 44.7%. Arytenoid asymmetry was seen commonest among the 5th and 6th decades of life and highest among the professional voice users (55%), while the male-to-female ratio was 1.6:1. Hoarseness constituted 40.1% of all indications for video-pharyngo-laryngoscopy, with 71% of patients with hoarseness having a primary laryngeal lesion, 26% had laryngopharyngeal reflux, and 3.3% were due to pubertal voice changes. A significant association was found between arytenoid asymmetry of the male gender P-value 0.027 and hoarseness P-value 0.026. Arytenoid adduction asymmetry is prevalent in the 5th and 6th decades of life, among patients with hoarseness resulting from unilateral primary laryngeal disorders.