Abstract
PurposeThis is a retrospective study to evaluate the results of surgical treatment of patients with pathological sulcus vocalis.MethodsThirty-six patients with pathological sulcus underwent surgery and in 33 cases were performed additional injection laryngoplasty. The pre- and postoperative evaluation of patients included the GRBAS scale, stroboscopic, and objective acoustic voice assessment. The Voice Handicap Index questionnaire (VHI-30) was also used and the scores were obtained from 33 patients.ResultsThe stroboscopic evaluation showed significant improvement of amplitude, mucosal wave, and glottal closure after treatment (p < 0.001). The VHI-30 scores decreased considerably indicating improvement due to the treatment for all aspects measured by VHI (p < 0.05, or p < 0.01). In all domains of GRBAS scale, the differences between preoperative and postoperative assessment were statistically significant (p < 0.001). We observed a significant change in Shim and APQ parameters (p < 0.05). Improvement was also observed in the sAPQ parameter, but it was not statistically significant (p = 0.051). For the remaining acoustic parameters, no changes were observed.ConclusionsThe surgical procedure with supplementary injection laryngoplasty of the vocal folds is a good treatment option for pathological sulcus vocalis. The post-treatment self-assessment indicates the significant improvement in VHI, just as perceptual–acoustic evaluation of voice does. Patients with pathological sulcus frequently present with amplitude disturbances, what explains their significant improvement after treatment.
Highlights
IntroductionSulcus vocalis is a laryngeal condition linked to a clinically inhomogeneous defect of the covering epithelium with structural malformation of the vocal fold, ranging from minor invagination to the deep focal pits
Sulcus vocalis is a laryngeal condition linked to a clinically inhomogeneous defect of the covering epithelium with structural malformation of the vocal fold, ranging from minor invagination to the deep focal pits.The classifications used today were introduced by Bouchayer and Cornut [1], and Ford [2]
Vergeture refers to an atrophic groove under the free edge of the vocal fold; sulcus 3 manifests as a pocket lined with a thick epithelium which goes as deep as the vocal ligament or muscle [1]
Summary
Sulcus vocalis is a laryngeal condition linked to a clinically inhomogeneous defect of the covering epithelium with structural malformation of the vocal fold, ranging from minor invagination to the deep focal pits. The classifications used today were introduced by Bouchayer and Cornut [1], and Ford [2]. Vergeture refers to an atrophic groove under the free edge of the vocal fold; sulcus 3 manifests as a pocket lined with a thick epithelium which goes as deep as the vocal ligament or muscle [1]. Ford and colleagues [2] extended this classification to account for the variability in clinical appearance and distinguished the physiologic sulcus (type 1) with normal or minimally altered mucosal wave and intact layered structure of the lamina propria.
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