Objectives/Hypothesis: Vocal fold sulcus and scars are benign vocal fold lesions that present as a challenge to the laryngologist. A number of different surgical techniques have been proposed, aiming at restoring the lamina propria (LP), closing the glottal gap, or both. This study aimed to provide a systematic review of surgical treatment for sulcus and scar and to propose a new classification for these techniques.Study Design: A literature search using MEDLINE and Google Scholar through August 2020.Methods: Data on study design were retrieved and outcomes were classified as acoustic, aerodynamic, self-reported, perceptual, and stroboscopic. Methodological quality was assessed using the MINORs criteria. Each technique was classified as direct, indirect, or combined.Results: Our search included 31 studies with a total of 617 patients. Direct techniques included dissection, graft interposition, or LP regeneration/scar degradation while indirect techniques aimed for glottal gap closure. Only one article performed a comparison between different types of techniques and only eight studied the five types of outcomes. No superiority of any technique was noted in our analysis. Self-reported outcomes were the most frequently improved.Conclusions: There seems to not exist a one-fits-all treatment for this clinical picture and no clear decision-making pattern. A recent trend toward sequential approaches, starting with less invasive procedures, can be observed.

Purpose The authors aim to review available reports on the potential effects of masks on voice and speech parameters. Methods A literature search was conducted using MEDLINE and Google Scholar databases through July 2021. Several targeted populations, mask scenarios and methodologies were approached. The assessed voice parameters were divided into self-reported, acoustic and aerodynamic. Results It was observed that the wearing of a face mask has been shown to induce several changes in voice parameters: (1) self-reported—significantly increased vocal effort and fatigue, increased vocal tract discomfort and increased values of voice handicap index (VHI) were observed; (2) acoustics—increased voice intensity, altered formants frequency (F2 and F3) with no changes in fundamental frequency, increased harmonics-to-noise ratio (HNR) and increased mean spectral values in high-frequency levels (1000–8000 Hz), especially with KN95 mask; (3) aerodynamics—maximum phonatory time was assessed in only two reports, and showed no alterations. Conclusion Despite the different populations, mask-type scenarios and methodologies described by each study, the results of this review outline the significant changes in voice characteristics with the use of face masks. Wearing a mask shows to increase the perception of vocal effort and an alteration of the vocal tract length and speech articulatory movements, leading to spectral sound changes, impaired communication and perception. Studies analyzing the effect of masks on voice aerodynamics are lacking. Further research is required to study the long-term effects of face masks on the potential development of voice pathology.

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