Decoding the Pharyngoarytenoid Fold: A Descriptive Study

Background:The anatomy of the larynx has been extensively studied and documented in the literature.It has significant implications in the diagnosis and management of various laryngeal pathologies.However, we aim to describe a new anatomical structure, a hitherto less described mucosal fold, the pharyngoarytenoid fold, that extends between the lateral pharyngeal wall and the arytenoid.Objectives: The aim of this study was to study the prevalence of the pharyngoarytenoid fold and to describe its types.Its association with demographic and anatomical factors will be studied.Methodology: This is a hospital-based cross-sectional study conducted in a tertiary care center for laryngology during the period from June to December 2023.A sample of 210 patients aged 18-60 years, who had visited the laryngology clinic for complaints other than that for speaking voice, were studied.The study was done using a Pentax VIVIDEO 3.2 mm chip-on-tip flexible laryngoscope.The presence and prevalence of the pharyngoarytenoid fold in the study population were described.The various patterns of the fold were described, and its association with demographic and anatomical factors was studied using the Chi-squared test.Results: In our study of 210 patients, there were 93 males (44.29%) and 117 females (55.71%).All patients studied had the pharyngoarytenoid fold, albeit with different patterns.The prevalence of the pharyngoarytenoid fold was 100%.There were three types of pharyngoarytenoid fold noted.Type I pattern was noted in 50 individuals (23.80%), type II pattern was noted in 70 individuals (33.33%), and type III pattern was noted in 90 people (42.86%).There was no significant association between gender or the presence of lymphoid follicles with the type of fold. Conclusion:The study concludes that the pharyngoarytenoid fold is a normal anatomical structure seen in all individuals.Cadaveric and postlaryngectomy intralaryngeal dissection would throw more light on the anatomy of this fold.A cadaveric dissection done showed the presence of this fold with its concavity posteriorly.The fact that it contains muscle fibers and its concavity faces posteriorly suggests that it plays a role in the pharyngeal phase of swallowing.Investigations like dynamic magnetic resonance imaging (MRI) will be helpful in assessing the function of this fold.