Vocal Sulcus
What is Vocal Sulcus?
Vocal sulcus is a structural disorder of the vocal cords. Unfortunately, it is frequently observed in our country. Our vocal cords normally consist of a muscle, a jelly-like substance (lamina propria) located on it, and an epithelial tissue covering it like skin. All units of this three-layered structure are critically important in voice production. In some individuals, this jelly-like substance of the vocal cord is deficient, and the covering skin-like tissue adheres directly to the muscle. This condition creates a channel-like depression in the vocal cord. This appearance is referred to as vocal sulcus. Consequently, vocal sulcus is a tissue deficiency in the vocal cords.
What causes vocal sulcus?
Vocal sulcus is present at birth in many patients or is detected from early childhood. Sometimes, prolonged misuse of the voice can also lead to scar tissue similar to vocal sulcus. It is observed more frequently in certain populations, and our country is among them.
What symptoms does it cause?
Patients with vocal sulcus experience two primary causes of hoarseness. The first is glottic insufficiency, which refers to the vocal cords’ inability to close completely due to tissue deficiency. The second reason is that the vocal cords cannot vibrate properly due to the missing jelly-like substance. These lead to the following symptoms:
– Voice fatigue
– Inability to raise one’s voice, difficulty being heard in crowded, noisy places
– A tired, weak, breathy voice
– Almost complete voice loss after prolonged speaking
– A creaky, rough voice quality
How is it treated?
Vocal sulcus is one of the difficult diseases to treat. Voice therapy is almost always the first option. With these therapies, we aim to enable more efficient and effective use of the voice despite all its deficiencies and problems. For patients who require additional treatment after voice therapy, surgeries targeting the components causing the complaints may be planned. These include vocal cord injection or vocal cord implant surgeries used for vocal cord closure problems, or vocal cord grafting surgery performed through the mouth to supplement the deficient vocal cord tissue. It is essential to create a personalized plan among these options based on the patient’s primary complaint.
