Sulcus vocalis is a voice disorder that causes perpetual hoarseness, vocal weakness and voice fatigue. The condition results from a thinning or loss of a layer of tissue along the vocal cord (vocal fold) called the superficial lamina propria. This layer of tissue normally vibrates during the production of sound. When it diminishes or disappears, a linear indentation called a sulcus is formed along the affected vocal cord and the patient has difficulty speaking. The raspy voice quality produced may ebb and flow, but will be ongoing without treatment.
Causes of Sulcus Vocalis
The precise causes of sulcus vocalis are unknown, but the condition may have genetic components. Possible factors leading to the development of this disorder are:
- Congenital defect
- Vocal trauma
- Degeneration of benign lesions
- Surgical complications
Some cases of sulcus vocalis may occur as a result of ruptured congenital epidermoid cysts, a disorder which appears to be hereditary.
Symptoms of Sulcus Vocalis
Patients with sulcus vocalis typically experience the following:
- Vocal fatigue
- Poor voice projection
- Breathy voice quality
Diagnosis of Sulcus Vocalis
Because the symptoms of sulcus vocalis are common to a number of other vocal disorders, the condition is confirmed by visual evidence of a groove along the edge of the vocal fold. While a laryngoscopy may be administered to diagnose sulcus vocalis, definitive diagnosis is typically made with a videostroboscopy, which requires the use of a thin scope and miniaturized video camera, monitor, microphone, and strobe light source.
The videostroboscopy is performed to assess the structure and movement of the vocal cords, and to examine surrounding muscles and tissues in the larynx. During a videostroboscopy, the vocal cords are visualized and recorded both at rest and as they vibrate during speech. The procedure is typically performed in the office of the otolaryngologist. laryngoscopy or videostroboscopy.
Treatment of Sulcus Vocalis
Anatomical change to the vocal fold as a result of sulcus vocalis is difficult to treat. Any underlying conditions affecting the region, such as allergies, laryngitis, or acid reflux, must first be addressed. Once this has been done, several treatment options are available, ranging from filler injections to microsurgical procedures. The decision about which method is most likely to be successful is made in terms of each individual case. Treatment options include:
- Injection laryngoplasty
- Microflap excision
- Graft implantation
Whichever treatment is used, a period of voice rest and ongoing voice therapy will be a part of the follow-up treatment.