Emre DEMİREL, Ozan ÇOLAK, Mustafa AKTAŞ, Muhammet Buğra ÖCAL, Özgür ÇITLAK, Emel TAHİR, Özgür KEMAL, Senem Çengel KURNAZ
Turkish Archives of Otorhinolaryngology - 2026;64(2):76-83
Objective: To describe the frequency and pattern of long-term postoperative swallowing abnormalities detected by flexible endoscopic evaluation of swallowing (FEES) after carbon dioxide (CO?) laser transverse posterior cordotomy for bilateral vocal fold paralysis (BVFP), and to relate these findings to patient-reported and functional swallowing measures. Methods: This retrospective, single-center cross-sectional study included 17 adults with BVFP who had previously undergone CO? laser transverse posterior cordotomy and were evaluated at a single postoperative time point between January and June 2025. Swallowing safety and efficiency were assessed using FEES with boluses representing International Dysphagia Diet Standardisation Initiative levels 0 (thin liquid; dyed water), level 3 (moderately thick; dyed yogurt), and level 7 (regular; cracker). Airway invasion and pharyngeal residue were graded using the Penetration-Aspiration Scale and Yale Pharyngeal Residue Severity Rating Scale. Functional Oral Intake Scale (FOIS), Functional Outcome Swallowing Scale (FOSS), and Eating Assessment Tool-10 scores were also recorded. Results: All participants were female (n=17; mean age 60.9+/-13.3 years) with a mean postoperative follow-up of 70.6+/-41.6 months. Penetration was common across consistencies; thin-liquid aspiration occurred in one patient. Vallecular and pyriform sinus residue was observed in a subset of patients. Most maintained full or near-full oral intake (FOIS 7, 76.5%) with mild functional limitation (FOSS 1-2, 94.1%). Conclusion: This descriptive postoperative series contributes objective FEES-based long-term swallowing data after CO? laser transverse posterior cordotomy in BVFP. FEES frequently demonstrated penetration and pharyngeal residue despite generally preserved oral intake, but these findings should not be interpreted as a treatment effect because baseline swallowing data were unavailable.
