Sulcus configurations of vocal folds during phonation

Lim, Jae Yol; Kim, Jaeock; Choi, Seong Hee; Kim, Kwang Moon; Kim, Young Ho; Kim, Hansu; Choi, Hong Shik

doi:10.1080/00016480802579058

Cited by 16 publications

(18 citation statements)

References 15 publications

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“…Only one individual displayed mild breathlessness ( Table 2 ). This result contradicts literature findings, 5 6 7 10 11 12 in which breathlessness is the primary auditory perception alteration in patients with sulcus vocalis. Hirano et al (1990) 11 assessed 126 patients with sulcus vocalis and most of the individuals exhibited mild breathlessness and hoarseness.…”

Section: Discussioncontrasting

confidence: 95%

“…The real incidence of sulcus vocalis is unknown, due to three factors: lack of knowledge of this laryngeal alteration, diagnostic error, or the absence of diagnosis when vocal symptoms are not serious enough to cause vocal complaints. 6 Currently, examinations such as videolaryngoscopy, videolaryngostroboscopy or suspension microlaryngoscopy are used to investigate morphological and structural changes in the vocal cords, although it is important to consider the data related to the clinical history of vocal alterations. 1 6 7 8 9…”

Section: Introductionmentioning

confidence: 99%

“…It is important to underscore that the sulcus vocalis is not always evident in videolaryngoscopy and often causes only slight structural alterations, although the vocal repercussions can be considerable. 2 6 7 8 Videolaryngostroboscopy can help assess a larynx with sulcus vocalis, showing a decline or absence of mucosal wave vibration. 1 9 However, under some circumstances, an accurate diagnosis of the sulcus vocalis can only be obtained by suspension microlaryngoscopy, the gold standard for diagnosing minimal structural changes.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Laryngeal and Vocal Characterization of Asymptomatic Adults With Sulcus Vocalis

Soares

Moares

Araújo

et al. 2019

Int Arch Otorhinolaryngol

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Introduction Sulcus vocalis is defined as a longitudinal depression on the vocal cord, parallel to its free border. Its most marked characteristic is breathlessness, caused by incomplete glottal closure, in addition to roughness, due to the decrease in mucosal wave amplitude of the vocal cords. Vocal acoustic aspects, such as fundamental voice frequency, jitter, and shimmer, may also be altered in individuals with this type of laryngeal disorder. To assess the voice of individuals with sulcus vocalis, studies generally include a sample of subjects with vocal symptoms, excluding asymptomatic persons. To better characterize the vocal characteristics of individuals with sulcus vocalis, their asymptomatic counterparts must also be included. Objective Characterize the larynx and voice of asymptomatic adults with sulcus vocalis. Method A total of 26 adults, 13 with sulcus vocalis (experimental group) and 13 without (control group) were assessed. All the participants were submitted to suspension microlaryngoscopy, voice self-assessment, auditory perception and acoustic evaluation of the voice. Results Among the individuals with sulcus vocalis, 78% of the sulci were type I and 22% type II. Auditory perception assessment obtained statistically significant lower scores in individuals with sulcus vocalis compared with the control group, and a slight difference in the overall degree of hoarseness and roughness. No statistically significant intergroup diferences were found in self-reported voice or acoustic assessment. Conclusion Type I was the predominant sulcus vocalis observed in individuals without voice complaints, who may also exhibit slight changes in vocal quality and roughness.

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Section: Discussioncontrasting

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Laryngeal and Vocal Characterization of Asymptomatic Adults With Sulcus Vocalis

Soares

Moares

Araújo

et al. 2019

Int Arch Otorhinolaryngol

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“…Deterioration of voice in sulcus cases varies markedly, but the majority of patients had a mild-to-moderate grade of hoarseness, roughness, breathiness, or strained voice [ 38 , 39 ]. Our results, as with other studies [ 11 , 23 , 25 , 37 ], showed a significant improvement of GRBAS scale parameters, although the patients’ voices remained hoarse after treatment.…”

Section: Discussionmentioning

confidence: 99%

Pathological sulcus vocalis: treatment approaches and voice outcomes in 36 patients

Miaśkiewicz

Szkiełkowska

Gos

et al. 2018

Eur Arch Otorhinolaryngol

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PurposeThis is a retrospective study to evaluate the results of surgical treatment of patients with pathological sulcus vocalis.MethodsThirty-six patients with pathological sulcus underwent surgery and in 33 cases were performed additional injection laryngoplasty. The pre- and postoperative evaluation of patients included the GRBAS scale, stroboscopic, and objective acoustic voice assessment. The Voice Handicap Index questionnaire (VHI-30) was also used and the scores were obtained from 33 patients.ResultsThe stroboscopic evaluation showed significant improvement of amplitude, mucosal wave, and glottal closure after treatment (p < 0.001). The VHI-30 scores decreased considerably indicating improvement due to the treatment for all aspects measured by VHI (p < 0.05, or p < 0.01). In all domains of GRBAS scale, the differences between preoperative and postoperative assessment were statistically significant (p < 0.001). We observed a significant change in Shim and APQ parameters (p < 0.05). Improvement was also observed in the sAPQ parameter, but it was not statistically significant (p = 0.051). For the remaining acoustic parameters, no changes were observed.ConclusionsThe surgical procedure with supplementary injection laryngoplasty of the vocal folds is a good treatment option for pathological sulcus vocalis. The post-treatment self-assessment indicates the significant improvement in VHI, just as perceptual–acoustic evaluation of voice does. Patients with pathological sulcus frequently present with amplitude disturbances, what explains their significant improvement after treatment.

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“…The pattern of glottal closure was rated on a 6-point scale according to Lim’s proposal 22 as follows: 0, complete closure; 1, anterior glottic chink; 2, posterior chink; 3, spindle glottic chink; 4, irregular glottic chink; 5, incomplete glottic closure (no glottal contact).…”

Section: Methodsmentioning

confidence: 99%

Voice aspects in sulcus coexisting with benign lesions of the vocal folds

Miaśkiewicz

Panasiewicz

Gos

et al. 2020

Acta Otorhinolaryngol Ital

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SUMMARY The purpose of this study was to measure the clinical profile of patients with sulcus who had concomitant benign lesions such as polyp, oedema, cyst, nodules, or fibrous mass of the vocal fold. We reviewed the medical charts of 38 patients who had a diagnosis of sulcus type 2 or 3 (according to Ford). The patients were classified into two groups. The study group consisted of 16 subjects who had sulcus and associated benign lesion; 22 patients diagnosed with sulcus alone were enrolled in a control group. We analysed psychosocial (Voice Handicap Index-30), auditory-perceptual (GRBAS), acoustic measures and videostroboscopic images. In the study group, the mean VHI-30 scores of all subscales ranged from moderate to severe handicap. The difference between groups was significant on the emotional (p = 0.004) and physical (p = 0.007) subscales. On GRBAS scale, the majority of patients from both groups exhibited mild hoarseness, breathiness, asthenic or strained voice, although roughness was more frequently rated moderate; the differences between groups were not statistically significant. The most abnormally increased values were achieved for amplitude values of acoustic parameters, but significant difference between groups was found in Soft Phonation Index only (p = 0.049). Concerning glottal closure, the most frequent finding was irregular chink in the study group, and spindle glottic chink in controls; we found significant differences between groups (p = 0.004). In both series of patients, the most frequent abnormal findings were moderately diminished amplitude and moderately restricted mucosal wave, with no significant difference between groups. Patients with sulcus and coexisting benign lesions were more handicapped on the emotional and physical subscales of VHI-30. The most characteristic shape of the glottal gap was irregular chink in the study group, and spindle chink in the control group. Acoustic evaluation of voice showed that the most severe disturbances affected amplitude parameters. The clinical characteristics indicated that the presence of sulcus primarily determines the quality of voice, and that additional benign pathologies do not drastically affect further voice deterioration. The coexistence of secondary benign vocal fold lesions aggravates the difficulties in making a preoperative diagnosis of sulcus. It is important to clinically suspect the possibility of coexistent sulcus to plan the correct treatment and obtain better voice outcomes.

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Sulcus configurations of vocal folds during phonation

Cited by 16 publications

References 15 publications

Laryngeal and Vocal Characterization of Asymptomatic Adults With Sulcus Vocalis

Laryngeal and Vocal Characterization of Asymptomatic Adults With Sulcus Vocalis

Pathological sulcus vocalis: treatment approaches and voice outcomes in 36 patients

Voice aspects in sulcus coexisting with benign lesions of the vocal folds

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