What is Sulcus Vocalis?
Sulcus vocalis is a structural disease of the vocal cords. Unfortunately, it is common in our country. Our vocal cords normally consist of a muscle, a jelly-like substance (lamina propria) and a tissue called epithelium that covers it like skin. All units of this three-layered structure are critical in voice formation. In some people, this jelly-like substance is missing and the covering skin-like tissue adheres directly to the muscle. This creates the appearance of a canal-like depression in the vocal cord. This appearance is called sulcus vocalis. In conclusion, sulcus vocalis is a tissue deficiency in the vocal cords.
Why/how is the sulcus vocalis formed?
In many patients the sulcus vocalis is present even at birth or is found to be present since early childhood. Sometimes prolonged misuse of the voice can also cause sulcus vocalis-like nebular tissue. It is more common in some societies. Our country is among these societies.
What symptoms does it cause?
There are two main causes of hoarseness in patients with sulcus vocalis. The first of these is the inability of the vocal cords to close completely, which we refer to as glottic insufficiency due to tissue deficiency in the vocal cords. The second reason is that the vocal cords cannot vibrate properly due to the missing jelly-like substance of the vocal cords. The following symptoms occur due to these:
– Quick fatigue of the voice
– Not being able to raise your voice, not being able to be heard in crowded noisy places
– A tired, weak, breathy voice
– Almost complete hoarsening of the voice after prolonged speech
– A scratchy rough quality sound
How to treat it?
Sulcus vocalis is one of the most difficult diseases to treat. Voice therapy is almost always the first option. With these therapies, we aim to ensure that the voice is used more efficiently and effectively despite all its deficiencies and problems. In patients who need additional treatment after voice therapy, surgeries can be planned for the components that cause complaints. These are either vocal cord filling or vocal cord implant surgeries that we use for vocal cord closure problems, or vocal cord grafting surgery that we perform by entering through the mouth to complete the missing tissue of the vocal cords. Among these options, it is essential to make a personal planning according to what the patient’s main complaint is.