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Sulcus vocalis: a review

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Abstract

Sulcus vocalis is described as a groove at the free edge of the vocal fold. Different types have been described: sulcus type I is superficial and may be considered as moreless physiologic. Sulcus type IIa corresponds to a kind of vergeture along the margin of the vocal fold. Its deepness is variable but sulcus vergeture may involve deeper layers of the lamina propria. Sulcus type IIb or pounch may be considered as an open cyst. Sulcus lead to a complex glottic dysfunction with, in the same time, a glottal leakage responsible for the breathy component of the dysphonia and a stiffness of the free edge responsible for the roughness. Diagnosis may be difficult even with the help of stroboscopy and finally is sometimes done only under general anesthesia. Etiology remains controversial and the authors present arguments for each theory, acquired or congenital. Treatment options include phonosurgery and speech therapy but phonosurgery gives results often disappointing and surgical treatment must be indicated prudently and patient must be intensively informed on what he or she can expect from the treatment that is mainly an increase of the loudness of the voice.

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References

  1. Chhetri DK, Head C, Revazova E, Hart S, Bhuta S, Berke G (2004) Lamina propria replacement therapy with cultured autologous fibroblasts for vocal fold scars. Otolaryngol Head Neck surg 131:864–870

    Article  PubMed  Google Scholar 

  2. Duflo S, Thibeault SL, Li W, Shu XZ, Prestwitch GD (2006) Vocal fold tissue repair in vivo using a synthetic extracellular matrix. Tissue Eng (in press)

  3. Ford CN (1999) Advances and refinements in phonosurgery. Laryngoscope 109:1891–1900

    Article  CAS  PubMed  Google Scholar 

  4. Ford CN, Inagi K, Khidr A, Bless DM, Gilchrist KW (1996) Sulcus vocalis: a rational approach to diagnosis and management. Ann Otol Rhinol Laryngol 105:189–200

    CAS  PubMed  Google Scholar 

  5. Ford CN (2004) G. Paul Moore lecture: lessons in phonosurgery. J Voice 18:534–544

    Article  PubMed  Google Scholar 

  6. Ford CN, Staskowski PA, Bless DM (1995) Autologous collagen vocal fold injection: a preliminary clinical study. Laryngoscope 105:944–948

    Article  CAS  PubMed  Google Scholar 

  7. Gray SD, Hirano M, Sato K (1993) Molecular and cellular structure of vocal fold tissue. In: Titze IR (ed) Vocal fold physiology. College-Hill Press, San Diego, pp 1–17

  8. Hirano M, Hirade Y, Yoshida T, Sanada T (1989) Improved surgical technique for epidermoid cysts of the vocal fold. Ann Otol Rhinol Laryngol 98:791–795

    CAS  PubMed  Google Scholar 

  9. Hirano M, Tanaka S, Yoshida T, Hibi s (1990) Sulcus vocalis: functional aspects. Ann Otol Rhinol Laryngol 99:679–683

    CAS  PubMed  Google Scholar 

  10. Hirschi SD, Gray SD, Thibeault SL (2002) Fibronectin: an interesting vocal fold protein. J Voice 16:310–316

    Article  PubMed  Google Scholar 

  11. Hsiung MW, Kang BH, Su WF, Pai LU, Lin YH (2004) Combination of fascia transplantation and fat injection into the vocal fold for sulcus vocalis: long-term results. Ann Otol Rhinol Laryngol 113:359–366

    PubMed  Google Scholar 

  12. Hsiung MW, Lin YZ, Su WF (2003) Autogenous fat injection for vocal fold atrophy. Eur Arch Otolaryngol 260:469–474

    Article  Google Scholar 

  13. Ishii H, Baba T, Kawabata I (1967) Clinical observations in the sulcus vocalis. J Otolaryngol 70:911–919

    Google Scholar 

  14. Isshiki N, Shoji K, Kojima H, Hirano S (1996) Vocal fold atrophy and its surgical treatment. Ann Otol Rhinol Laryngol 105:182–188

    CAS  PubMed  Google Scholar 

  15. Isshiki N, Taira T, Kojima H, Shoji K (1989) Recent modifications in thyroplasty type I. Ann Otol Rhinol Laryngol 98:777–779

    CAS  PubMed  Google Scholar 

  16. Itoh T, Kawazaki H, Morikawa I, Hirano M (1983) Vocal fold furrows. A 10-year review of 240 patients. Auris Nasus Larynx (Tokyo) 10(Suppl.):S17–S26

    Google Scholar 

  17. Lindestad PA, Hertegard S (1994) Spindle-shaped glottal insufficiency with and without sulcus vocalis: a retrospective study. Ann Otol Rhinol Laryngol 103:547–553

    CAS  PubMed  Google Scholar 

  18. Luchsinger R, Arnold GE (1965) Voice, speech, language, clinical communicology: its physiology, pathology.Wadsworth Publishing, Belmont, pp 171–175

  19. Monday LA, Bouchayer M, Cornut G, Roch JB (1983) Epidermoid cysts of the vocal cords. Ann Otol Rhinol Laryngol 92:124–127

    CAS  PubMed  Google Scholar 

  20. Nakayama M, Ford CN, Brandenburg JH, Bless DM (1994) Sulcus vocalis in laryngeal cancer: a histopathologic study. Laryngoscope 104:16–24

    Article  CAS  PubMed  Google Scholar 

  21. Omori K, Slavit DH, Kacker A, Blaugrund SM (1998) Influence of the size and etiology of glottal gap in glottic incompetence dysphonia. Laryngoscope 108:514–518

    Article  CAS  PubMed  Google Scholar 

  22. Pontes P, Belhau M (1993) Treatment of sulcus vocalis: auditory perceptual and acoustic analysis of the slicing mucosa surgical technique. J Voice 7:365–376

    Article  CAS  PubMed  Google Scholar 

  23. Remacle M, Lawson G, Watelet JB (1999) Carbon dioxide laser microsurgery of benign vocal fold lesions: indications, techniques, and results in 251 patients. Ann Otol Rhinol Laryngol 108:156–164

    CAS  PubMed  Google Scholar 

  24. Remacle M, Lawson G, Keghian J, Jamart J (1999) Use of injectable autologous collagen for correcting glottic gaps. Ann Otol Rhinol Laryngol 108(8):788–793

    CAS  PubMed  Google Scholar 

  25. Remacle M, Lawson G, Evrard I, Degols JC, Jamart J (2000) Microsurgery of sulcus vergeture with carbon dioxide laser and injectable collagen. Ann Otol Rhinol Laryngol 109:141–148

    CAS  PubMed  Google Scholar 

  26. Sato K, Hirano M (1998) Electron microscopic investigation of sulcus vocalis. Ann Otol Rhinol Laryngol 107:56–60

    CAS  PubMed  Google Scholar 

  27. Stephen TS, Lee FRCS, Niimi DM (1990) Vocal fold sulcus. J Laryngol Otol 104:876–878

    Google Scholar 

  28. Su CY, Tsai SS, Chiu JF, Cheng CA (2004) Medialization laryngoplasty with strap muscle transposition for vocal fold atrophy with or without sulcus vocalis. Laryngoscope 114:1106–1112

    Article  PubMed  Google Scholar 

  29. Tanaka S, Hirano M, Chijiwa K (1994) Some aspects of vocal fold bowing. Ann Otol Rhinol Laryngol 103:357–362

    CAS  PubMed  Google Scholar 

  30. Tsunoda K, Takanosawa M, Nümi S (1999) Autologous transplantation of fascia into the vocal fold: a new phonosurgical technique for glottal incompetence. Laryngoscope 109:504–508

    Article  CAS  PubMed  Google Scholar 

  31. Wallesch B, Johanssen HS (1989) Über die Ätiologie des Sulcus glottidis. Laryngorhinootol 68:506–509

    CAS  Google Scholar 

  32. Ward PD, Thibeault SL, Gray S (2002) Hyaluronic acid: its role in voice. J Voice 16:303–309

    Article  PubMed  Google Scholar 

  33. Witzig E, Cornut G, Bouchayer M, Roch JB, Loire R (1983) Etude anatomo-clinique et traitement du kyste épidermoïde et du sulcus de la corde vocale: à propos de 157 cas. Les Cahiers d’ORL T. XVIII. N 9:765–778

    Google Scholar 

  34. Woo P, Rahbar R, Wang Z (1999) Fat implantation into Reinke’s space: a histologic and stroboscopic study in the canine. Ann Otol Rhinol Laryngol 108:738–744

    CAS  PubMed  Google Scholar 

  35. Yu P, Nicollas R, Garrel R, Ouaknine M, Giovanni A. Objective analysis of voice production with EVA device in dysphonia in women

  36. Zeitels SM, Mauri M, Dailey SH (2003) Medialization laryngoplasty with Gore-Tex voice restoration secondary to glottal incompetence: indications and observations. Ann Otol Rhinol Laryngol 112:180–184

    PubMed  Google Scholar 

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Correspondence to Antoine Giovanni.

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Giovanni, A., Chanteret, C. & Lagier, A. Sulcus vocalis: a review. Eur Arch Otorhinolaryngol 264, 337–344 (2007). https://doi.org/10.1007/s00405-006-0230-8

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