Sulcus Vocalis Workup

  • Author: John Schweinfurth, MD; Chief Editor: Arlen D Meyers, MD, MBA   more...
 
Updated: Jun 15, 2010
 

Other Tests

Refer patients with symptoms of hoarseness, loss of range, or voice fatigue with no obvious laryngeal pathology to a laryngologist for further evaluation, preferably to an otolaryngologist with special interest and training in diagnosis and treatment of voice disorders. Sulcus vocalis is a challenging rare disorder and often is best treated by a subspecialist.

A laryngologist usually employs a team approach to the diagnosis and treatment of voice disorders (eg, speech pathologist, singing voice specialist) and has a variety of specialized endoscopes that allow for detailed examination of the larynx.

Videostroboscopy is an important tool used by the laryngologist. This imaging system is controlled in part by the patient's vocal pitch, allowing for slow-motion video recording of vocal fold vibration. Examination of the true vocal fold reveals a linear depression or an area of incomplete closure. Videostroboscopy reveals an area of decreased mucosal wave corresponding to the sulcus and more clearly shows associated incomplete closure.

Other diagnostic studies commonly employed by the laryngologist include acoustic and airflow measurements.

  • Acoustic analysis reveals some information about vocal production efficiency and voice strength.
  • Airflow measurements are useful in gauging vocal support and glottic constriction.
Proceed to Treatment & Management
 
 
Contributor Information and Disclosures
Author

John Schweinfurth, MD  Professor, Department of Otolaryngology, University of Mississippi Medical Center

John Schweinfurth, MD is a member of the following medical societies: American Academy of Otolaryngic Allergy, American Academy of Otolaryngology-Head and Neck Surgery, American Laryngological Association, American Medical Association, and Triological Society

Disclosure: Nothing to disclose.

Coauthor(s)

Robert H Ossoff, DMD, MD  Assistant Vice-Chancellor for Compliance and Corporate Integrity and Maness Professor of Laryngology and Voice, Vanderbilt Medical Center

Robert H Ossoff, DMD, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American Bronchoesophagological Association, American College of Chest Physicians, American College of Surgeons, American Laryngological Association, American Laryngological Rhinological and Otological Society, American Medical Association, American Rhinologic Society, American Society for Head and Neck Surgery, American Society for Laser Medicine and Surgery, Sigma Xi, and Southeastern Surgical Congress

Disclosure: Nothing to disclose.

Specialty Editor Board

Clark A Rosen, MD  Director, University of Pittsburgh Voice Center; Professor, Department of Otolaryngology and Communication Science and Disorders, University of Pittsburgh School of Medicine

Clark A Rosen, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, and Pennsylvania Medical Society

Disclosure: Bioform Medical Consulting fee Consulting; Bioform Medical Consulting fee Speaking and teaching

Francisco Talavera, PharmD, PhD  Senior Pharmacy Editor, eMedicine

Disclosure: eMedicine Salary Employment

Stephen G Batuello, MD  Consulting Staff, Colorado ENT Specialists

Stephen G Batuello, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American College of Physician Executives, American Medical Association, and Colorado Medical Society

Disclosure: Nothing to disclose.

Christopher L Slack, MD  Otolaryngology-Facial Plastic Surgery, Private Practice, Associated Coastal ENT; Medical Director, Treasure Coast Sleep Disorders

Christopher L Slack, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Medical Association

Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA  Professor, Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine

Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Head and Neck Society

Disclosure: Covidien Corp Consulting fee Consulting; US Tobacco Corporation unstricted gift unknown; Axis Three Corporation Ownership interest Consulting; Omni Biosciences Ownership interest Consulting; Sentegra Ownership interest Board membership; Syndicom Ownership interest Consulting; Oxlo Consulting; Medvoy Ownership interest Management position; Cerescan Imaging Honoraria Consulting; GYRUS ACMI Honoraria Consulting

References

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  2. Bouchayer M, Cornut G, Witzig E, et al. Epidermoid cysts, sulci, and mucosal bridges of the true vocal cord: a report of 157 cases. Laryngoscope. Sep 1985;95(9 Pt 1):1087-94. [Medline].

  3. Archer SM, Banks ER. Intracordal injection of autologous fat for augmentation of the mucosally damaged canine vocal fold: a long-term histologic study. 2nd World Congress on Laryngeal Cancer. 1994.

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  17. Varela DG, Grellet M. [Vocal fold superficial layer of lamina propria histology after the position of mucosa pediculated flap: canine experimental study]. Braz J Otorhinolaryngol. May-Jun 2005;71(3):318-24. [Medline].

  18. Yanagihara N. Significance of harmonic changes and noise components in hoarseness. J Speech Hear Res. Sep 1967;10(3):531-41. [Medline].

 
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Linear sulcus nearly the length of the true vocal fold.
Sulcus under normal light indirect laryngoscopy: Note the very subtle appearance.
Sulcus under stroboscopy: Note the defect in the vibratory surface caused by the sulcus.
 
 
 
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