These procedures are used to treat bilateral vocal fold paralysis, where both vocal cords are stuck in a closed position, blocking the airway. An arytenoidectomy involves removing part of one of the arytenoid cartilages (which control vocal fold movement) to open the airway. An arytenoidpexy involves repositioning and securing the arytenoid cartilage to improve breathing while trying to preserve voice and swallowing.

The surgery is performed under general anesthesia through a neck incision or sometimes endoscopically, these procedures help patients breathe more freely without relying on a permanent tracheostomy. When done for voice, it repositions the arytenoid cartilage into the proper position. There is a brief hospital stay after surgery to monitor breathing and swallowing. Recovery includes voice rest, monitoring for airway swelling, and gradual reintroduction of speech. The voice may become weaker or breathier after the procedure due to the more open vocal folds, but most patients can communicate effectively. Risks include scarring, aspiration, or need for revision surgery, but results are often life-changing for those struggling to breathe.