International Journal of Phonosurgery & Laryngology

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VOLUME 8 , ISSUE 1 ( January-June, 2018 ) > List of Articles

ORIGINAL ARTICLE

Sulcus Vocalis: Our Experience

Abhishek Gupta, Sukamal Das, Chandan Saha, Baisakhi Bakat, Soumitra Ghosh, Barin K Roychaudhuri

Keywords : Vocal fold, Voice therapy,Sulcus vocalis

Citation Information : Gupta A, Das S, Saha C, Bakat B, Ghosh S, Roychaudhuri BK. Sulcus Vocalis: Our Experience. Int J Phonosurg Laryngol 2018; 8 (1):36-40.

DOI: 10.5005/jp-journals-10023-1156

License: CC BY-NC 3.0

Published Online: 00-06-2018

Copyright Statement:  Copyright © 2018 Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Aims and objectives: • Evaluate the incidence of sulcus vocalis. • To document and analyze the outcome of treatment of sulcus vocalis. Materials and methods: A prospective observational study, conducted over 1 year, at a tertiary care teaching hospital in the department of ENT and Head-Neck surgery. Patients attending a voice clinic with dysphonia were included in the study. The diagnosis was made by fiberoptic laryngoscopy (FOL) and confirmed by stroboscopy. Patients were classified into types I, II or III according to Ford classification (1996). Conservative management in the form of vocal hygiene and voice therapy was advocated for all patients. No improvement warranted surgery. Subjective voice handicap index-10 (VHI-10) and objective evaluation (FOL) was performed at diagnosis and at 3 and 6 months of follow-up. The minimum follow-up period was 6 months. Results: A total of 167 patients attended the voice clinic for 6 months, of which 23 cases were diagnosed with sulcus vocalis. Of these 10 were females and 13 were males. 10 cases were categorized as type I, 9 as type II and 3 as type III. One patient had type II sulcus on right vocal fold and type I on the left side. All 10 cases of type I were treated satisfactorily by voice therapy. Out of 9 cases of Type II, 8 underwent microlaryngoscopic fat injection following voice therapy whereas 1 case was improved by voice therapy alone. In type III, patients 2 underwent fat implantation whereas 1 case underwent fat injection on one side and fat implantation on the other. All patients underwent post-operative voice therapy for 6 months. The reasonably good vocal outcome was noted during follow-up at 3 and 6 months. Conclusion: Sulcus vocalis is not a very uncommon condition. Fibreoptic laryngoscopy aided with stroboscopy can confirm the diagnosis in all cases. Type I responds well to voice therapy. In case of type II and III sulcus, the reasonably good vocal outcome is achieved with surgical intervention, followed by prolonged voice therapy.


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