Spindle-shaped glottis: Sulcus vocalis, presbilarynx and other causes

Abstract

Spindle-shaped glottal insufficiency may appear at any age. This disorder significantly affect the voice quality and hence the life quality. Degenerative, neuromuscular, inflammatory, functional, iatrogenic and psychogenic originated pathologies can lead to spindle-shaped glottal insufficiency. Sulcus vocalis, vocal scars and presbylarynx constitutes degenerative causes. The term sulcus vocalis is used to describe a groove at the free edge of the vocal folds resulting in an area of mucosal stiffness and giving the vocal folds a bowed aspect during phonation. It may involve all or any segment of the edge of the fold. The defect may be confined to the superficial layer of the mucosa or penetrate deeply in the vocal ligament and muscle. According to involvement, three types have been described. Etiology remains controversial and the authors present arguments for each theory, acquired or congenital. The term lpresbylarynx\' denotes vocal changes due to aging of the larynx. Symptoms are characterized by poor vocal projection, shorter phonation duration and vocal roughness. Videolaryngostroboscopy is a highly effective diagnostic tool for spindle-shaped glottal insufficiency. The glottis is spindle-shaped during phonation and vibration is frequently asymmetrical and reduced in amplitude. Because of closing defects; median line air leakage is observed in the anterior two-thirds of the vocal folds during phonation. Treatment options include phonosurgery and speech therapy in spindle-shaped glottis. The aim of the present paper is to review the reasons of vocal fold curvature, particularly presbylarynx and sulcus vocalis, and the clinical features of spindle-shaped glottal insufficiency.