Sulcus vocalis: a review

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.

Sulcus Vocalis (Type III): Prevalence and Strobovideolaryngoscopy Characteristics

“…3 Type I is a physiological sulcus, whereas types II and III are pathologic. 3,4 Type II, or sulcus vergeture, is a groove in the vocal fold from atrophy of the superficial layer of the lamina propria. 3,4 Type III, or sulcus vocalis (SV), is a pit in the vocal fold edge.…”

“…3,4 Type II, or sulcus vergeture, is a groove in the vocal fold from atrophy of the superficial layer of the lamina propria. 3,4 Type III, or sulcus vocalis (SV), is a pit in the vocal fold edge. 3,4 There is absence of the superficial lamina propria with epithelium adherent to the vocal ligament, and there can be involvement of the vocalis muscle ( Figure 1).…”

“…3,4 Type III, or sulcus vocalis (SV), is a pit in the vocal fold edge. 3,4 There is absence of the superficial lamina propria with epithelium adherent to the vocal ligament, and there can be involvement of the vocalis muscle ( Figure 1). Type III sulcus may have the appearance of an open cyst with thickened epithelium.…”

Videographic Documentation of an Open Cyst Converting Into a Sulcus Vocalis

“…They may also be acquired because they are also often associated with other pathological processes and inflammation. 1,8 In this case, the patient initially presented with dysphonia as a result of a left sided intracordal cyst. Once this was removed, her voice returned to normal despite there being a small intracordal cyst on the opposite fold.…”

“…1 It remains uncertain whether pathological sulci are congenital or acquired. The hypothesis that sulcus vocalis was congenital and represents a ruptured epidermoid cyst was first advanced by Bouchayer et al 7 and has been supported by Giovanni et al 8 but has never been proven. They may also be acquired because they are also often associated with other pathological processes and inflammation.…”