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Sulcus Vocalis Workup

  • Author: John Schweinfurth, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
Updated: Mar 25, 2016

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.
Contributor Information and Disclosures

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 Laryngological Association, Triological Society, American Academy of Otolaryngology-Head and Neck Surgery, American Medical Association

Disclosure: Nothing to disclose.


Robert H Ossoff, DMD, MD Maness Professor of Laryngology and Voice, Department of Otolaryngology, Executive Medical Director, Vanderbilt Voice Center, Vanderbilt Medical Center

Robert H Ossoff, DMD, MD is a member of the following medical societies: American Head and Neck Society, 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, The Triological Society, American Medical Association, American Rhinologic Society, American Society for Laser Medicine and Surgery, Sigma Xi, Southeastern Surgical Congress

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

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 Association for Physician Leadership, American Medical Association, Colorado Medical Society

Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA Professor of Otolaryngology, Dentistry, and Engineering, 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, American Head and Neck Society

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Cerescan;RxRevu;SymbiaAllergySolutions<br/>Received income in an amount equal to or greater than $250 from: Symbia<br/>Received from Allergy Solutions, Inc for board membership; Received honoraria from RxRevu for chief medical editor; Received salary from Medvoy for founder and president; Received consulting fee from Corvectra for senior medical advisor; Received ownership interest from Cerescan for consulting; Received consulting fee from Essiahealth for advisor; Received consulting fee from Carespan for advisor; Received consulting fee from Covidien for consulting.

Additional Contributors

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, Pennsylvania Medical Society

Disclosure: Serve(d) as a speaker or a member of a speakers bureau for: Merz North America Inc<br/>Received consulting fee from Merz North America Inc for consulting; Received consulting fee from Merz North America Inc for speaking and teaching.

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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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