Skip to main content
Top
Published in: European Archives of Oto-Rhino-Laryngology 11/2018

Open Access 01-11-2018 | Laryngology

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

Authors: Beata Miaśkiewicz, Agata Szkiełkowska, Elżbieta Gos, Aleksandra Panasiewicz, Elżbieta Włodarczyk, Piotr H. Skarżyński

Published in: European Archives of Oto-Rhino-Laryngology | Issue 11/2018

Login to get access

Abstract

Purpose

This is a retrospective study to evaluate the results of surgical treatment of patients with pathological sulcus vocalis.

Methods

Thirty-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.

Results

The 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.

Conclusions

The 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.
Literature
1.
go back to reference Bouchayer M, Cornut G, Loire R, Witzig E, Roch JB, Bastian R (1985) Epidermoid cyst, sulci, and mucosal bridges of the true vocal cord: a report of 157 cases. Laryngoscope 95(9):1087–1094CrossRef Bouchayer M, Cornut G, Loire R, Witzig E, Roch JB, Bastian R (1985) Epidermoid cyst, sulci, and mucosal bridges of the true vocal cord: a report of 157 cases. Laryngoscope 95(9):1087–1094CrossRef
2.
go back to reference Ford CN, Inagi K, Bless DM, Khidr A, Gilchrist KW (1996) Sulcus vocalis: a rational analytical approach to diagnosis and management. Ann Otol Rhinol Laryngol 105:189–200CrossRef Ford CN, Inagi K, Bless DM, Khidr A, Gilchrist KW (1996) Sulcus vocalis: a rational analytical approach to diagnosis and management. Ann Otol Rhinol Laryngol 105:189–200CrossRef
3.
go back to reference Ishii H, Baba T, Kawabata I (1967) Clinical observations in the sulcus vocalis. J Otolaryngol 70:911–919 Ishii H, Baba T, Kawabata I (1967) Clinical observations in the sulcus vocalis. J Otolaryngol 70:911–919
4.
go back to reference Shin Y (1976) Clinical and pathological investigations of sulcus vocalis. Otologia (Fukuoka) 22:819–835 Shin Y (1976) Clinical and pathological investigations of sulcus vocalis. Otologia (Fukuoka) 22:819–835
5.
go back to reference Hsiung MW, Woo P, Wang HW (2000) A clinical classification and histopathological study of sulcus vocalis. Eur Arch Otorhinolaryngol 257:466–468CrossRef Hsiung MW, Woo P, Wang HW (2000) A clinical classification and histopathological study of sulcus vocalis. Eur Arch Otorhinolaryngol 257:466–468CrossRef
6.
go back to reference Sunter AV, Yigit O, Huq GE, Alkan Z, Kocak I, Buyuk Y (2011) Histopathological characteristics of sulcus vocalis. Otolaryngol Head Neck Surg 145(2):264–269CrossRef Sunter AV, Yigit O, Huq GE, Alkan Z, Kocak I, Buyuk Y (2011) Histopathological characteristics of sulcus vocalis. Otolaryngol Head Neck Surg 145(2):264–269CrossRef
7.
go back to reference Husain S, Sulica L (2016) Familial sulcus vergeture: further evidence for origin of type 2 sulcus. J Voice 30(6):761.e19–761.e21CrossRef Husain S, Sulica L (2016) Familial sulcus vergeture: further evidence for origin of type 2 sulcus. J Voice 30(6):761.e19–761.e21CrossRef
8.
go back to reference Nakayama M, Ford CN, Brandenburg JH, Bless DM (1994) Sulcus vocalis in laryngeal cancer: a histopathologic study. Laryngoscope 104:16–24CrossRef Nakayama M, Ford CN, Brandenburg JH, Bless DM (1994) Sulcus vocalis in laryngeal cancer: a histopathologic study. Laryngoscope 104:16–24CrossRef
9.
go back to reference Lee A, Sulica L, Aylward A, Scognamiglio T (2016) Sulcus vocalis; a new histopathological paradigm based on a reevaluation of histology. Laryngoscope 126:1397–1403CrossRef Lee A, Sulica L, Aylward A, Scognamiglio T (2016) Sulcus vocalis; a new histopathological paradigm based on a reevaluation of histology. Laryngoscope 126:1397–1403CrossRef
10.
go back to reference Miaśkiewicz B, Szkiełkowska A (2015) Diagnostic difficulties in sulcus vocalis. Now Audiofonol 4(1):60–63 Miaśkiewicz B, Szkiełkowska A (2015) Diagnostic difficulties in sulcus vocalis. Now Audiofonol 4(1):60–63
11.
go back to reference Miaśkiewicz B, Szkiełkowska A, Piłka A, Skarżyński H (2015) Results of surgical treatment in patients with sulcus vocalis. Otolaryngol Pol 69(6):7–14CrossRef Miaśkiewicz B, Szkiełkowska A, Piłka A, Skarżyński H (2015) Results of surgical treatment in patients with sulcus vocalis. Otolaryngol Pol 69(6):7–14CrossRef
12.
go back to reference Giovanni A, Chanteret C, Lagier A (2007) Sulcus vocalis: a review. Eur Arch Otorhinolaryngol 264:337–344CrossRef Giovanni A, Chanteret C, Lagier A (2007) Sulcus vocalis: a review. Eur Arch Otorhinolaryngol 264:337–344CrossRef
13.
go back to reference Friedrich G, Dikkers FG, Arens C (2013) Vocal fold scars: current concepts and future directions. Consensus report of the phonosurgery committee of the European Laryngological Society. Eur Arch Otorhinolaryngol 270:2491–2507CrossRef Friedrich G, Dikkers FG, Arens C (2013) Vocal fold scars: current concepts and future directions. Consensus report of the phonosurgery committee of the European Laryngological Society. Eur Arch Otorhinolaryngol 270:2491–2507CrossRef
14.
go back to reference Jacobson B, Johnson A, Grywalski C, Silbergleit A, Jacobson G, Benninger M (1997) The Voice Handicap Index (VHI): development and validation. Am J Speech Lang Pathol 6:66–69CrossRef Jacobson B, Johnson A, Grywalski C, Silbergleit A, Jacobson G, Benninger M (1997) The Voice Handicap Index (VHI): development and validation. Am J Speech Lang Pathol 6:66–69CrossRef
15.
go back to reference Hirano M (1981) Psycho-acoustic evaluation of voice. In: Arnold GE, Winckel F, Wyke BD (eds) Clinical examination of voice. Springer, New York, pp 81–84 Hirano M (1981) Psycho-acoustic evaluation of voice. In: Arnold GE, Winckel F, Wyke BD (eds) Clinical examination of voice. Springer, New York, pp 81–84
16.
go back to reference Ping Y, Ouaknine M, Revis J, Giovanni A (2001) Objective voice analysis for dysphonic patients: a multiparametric protocol including acoustic and aerodynamic measurements. J Voice 15(4):529–542CrossRef Ping Y, Ouaknine M, Revis J, Giovanni A (2001) Objective voice analysis for dysphonic patients: a multiparametric protocol including acoustic and aerodynamic measurements. J Voice 15(4):529–542CrossRef
17.
go back to reference Revis J, Giovanni A, Wuyts FL, Triglia JM (1999) Comparison of different voice samples for perceptual analysis. Folia Phoniatr Logop 51:108–116CrossRef Revis J, Giovanni A, Wuyts FL, Triglia JM (1999) Comparison of different voice samples for perceptual analysis. Folia Phoniatr Logop 51:108–116CrossRef
18.
go back to reference Schindler A, Mozzanica F, Vedrody M, Marruzi P, Ottaviani F (2009) Correlation between the Voice Handicap Index and voice measurements in four groups of patients with dysphonia. Otolaryngol Head Neck Surg 141:762–769CrossRef Schindler A, Mozzanica F, Vedrody M, Marruzi P, Ottaviani F (2009) Correlation between the Voice Handicap Index and voice measurements in four groups of patients with dysphonia. Otolaryngol Head Neck Surg 141:762–769CrossRef
19.
go back to reference Maryn Y, Corthals P, de Bodt M, Cauwenberge P, Deliyski D (2009) Perturbation measures of voice: a comparative study between Multi-Dimensional Voice Program and Praat. Folia Phoniatr Logop 61:217–226CrossRef Maryn Y, Corthals P, de Bodt M, Cauwenberge P, Deliyski D (2009) Perturbation measures of voice: a comparative study between Multi-Dimensional Voice Program and Praat. Folia Phoniatr Logop 61:217–226CrossRef
20.
go back to reference Nicastri M, Chiarella G, Gallo LV, Catalano M, Cassandro E (2004) Multidimensional Voice Program (MDVP) and amplitude variation parameters in euphonic adult subjects. Normative study. Acta Otorhinolaryngol Ital 24:337–341PubMed Nicastri M, Chiarella G, Gallo LV, Catalano M, Cassandro E (2004) Multidimensional Voice Program (MDVP) and amplitude variation parameters in euphonic adult subjects. Normative study. Acta Otorhinolaryngol Ital 24:337–341PubMed
21.
go back to reference Bouchayer M, Cornut G (1992) Microsurgical treatment of benign vocal fold lesions: indications, technique, results. Folia Phoniatr (Basel) 44:155–184CrossRef Bouchayer M, Cornut G (1992) Microsurgical treatment of benign vocal fold lesions: indications, technique, results. Folia Phoniatr (Basel) 44:155–184CrossRef
22.
go back to reference Remacle M, Lawson G, Evrard I, Degols JC, Jamart J (2000) Microsurgery of sulcus vergeture with carbon dioxide laser and injectable collagen. Ann Otol Rhinol Laryngol 109(2):141–148CrossRef Remacle M, Lawson G, Evrard I, Degols JC, Jamart J (2000) Microsurgery of sulcus vergeture with carbon dioxide laser and injectable collagen. Ann Otol Rhinol Laryngol 109(2):141–148CrossRef
23.
go back to reference Yilmaz T (2012) Sulcus vocalis: excision, primary suture and medialization laryngoplasty: personal experience with 44 cases. Eur Arch Otorhinolaryngol 269:2381–2389CrossRef Yilmaz T (2012) Sulcus vocalis: excision, primary suture and medialization laryngoplasty: personal experience with 44 cases. Eur Arch Otorhinolaryngol 269:2381–2389CrossRef
24.
go back to reference Welham NV, Choi SH, Dailey SH, Ford CN, Jiang JJ, Bless D (2011) Prosective multi-arm evaluation of surgical treatment for vocal fold scar and pathologic sulcus vocalis. Laryngoscope 121:2152–2160CrossRef Welham NV, Choi SH, Dailey SH, Ford CN, Jiang JJ, Bless D (2011) Prosective multi-arm evaluation of surgical treatment for vocal fold scar and pathologic sulcus vocalis. Laryngoscope 121:2152–2160CrossRef
25.
go back to reference Pitman MJ, Rubino SM, Cooper AL (2014) Temporalis fascia transplant for vocal scar and sulcus vocalis. Laryngoscope 124:1653–1658CrossRef Pitman MJ, Rubino SM, Cooper AL (2014) Temporalis fascia transplant for vocal scar and sulcus vocalis. Laryngoscope 124:1653–1658CrossRef
26.
go back to reference Deliyski DD (1993) Acoustic model and the evaluation of pathological voice production. In: Reprint form the proceedings: 3-rd Conference on Speech Communication and Technology Eurospeech’93, Berlin, Germany, 1969–1972 Deliyski DD (1993) Acoustic model and the evaluation of pathological voice production. In: Reprint form the proceedings: 3-rd Conference on Speech Communication and Technology Eurospeech’93, Berlin, Germany, 1969–1972
27.
go back to reference Kay Elemetrics Corp (2003) Multidimensional Voice Program (MDVP) Model 5105: software instruction manual. Lincoln Park, Chicago Kay Elemetrics Corp (2003) Multidimensional Voice Program (MDVP) Model 5105: software instruction manual. Lincoln Park, Chicago
28.
go back to reference Kay Elemetrics Corp (2004) Multi-speech and CSL software: software instruction manual. Lincoln Park, Chicago Kay Elemetrics Corp (2004) Multi-speech and CSL software: software instruction manual. Lincoln Park, Chicago
29.
go back to reference Matar N, Remacle M, Amousa K, Lawson G (2011) CO2 laser digital scanning system and injectable collagen for treatment of sulcus vocalis. Oper Tech Otolaryngol 22:155–158CrossRef Matar N, Remacle M, Amousa K, Lawson G (2011) CO2 laser digital scanning system and injectable collagen for treatment of sulcus vocalis. Oper Tech Otolaryngol 22:155–158CrossRef
30.
go back to reference Pontes P, Behlau M (1993) Treatment of sulcus vocalis: auditory perceptual and acoustical analysis of the slicing mucosa surgical technique. J Voice 7:365–376CrossRef Pontes P, Behlau M (1993) Treatment of sulcus vocalis: auditory perceptual and acoustical analysis of the slicing mucosa surgical technique. J Voice 7:365–376CrossRef
31.
go back to reference Szkiełkowska A, Miaśkiewicz B, Remacle M, Krasnodębska P, Skarżyński H (2013) Quality of voice after augmentation of hyaluronic acid to the vocal fold. Med Sci Monit 19:276–282CrossRef Szkiełkowska A, Miaśkiewicz B, Remacle M, Krasnodębska P, Skarżyński H (2013) Quality of voice after augmentation of hyaluronic acid to the vocal fold. Med Sci Monit 19:276–282CrossRef
32.
go back to reference Miaśkiewicz B, Szkiełkowska A (2014) Long-term follow up in injection laryngoplasty with hyaluronic acid. Otolaryngol Pol 13(3):147–154 Miaśkiewicz B, Szkiełkowska A (2014) Long-term follow up in injection laryngoplasty with hyaluronic acid. Otolaryngol Pol 13(3):147–154
33.
go back to reference Branco A, Rodrigues SA, Fabro AT, Fonseca-Alves CE, Martins RH (2014) Hyaluronic acid behavior in the lamina propria of the larynx with advancing age. Otolaryngol Head Neck Surg 151(4):652–656CrossRef Branco A, Rodrigues SA, Fabro AT, Fonseca-Alves CE, Martins RH (2014) Hyaluronic acid behavior in the lamina propria of the larynx with advancing age. Otolaryngol Head Neck Surg 151(4):652–656CrossRef
34.
go back to reference King M, Simpson B (2007) Modern augmentation for glottic insufficiency. Curr Opin Otolaryngol Head Neck Surg 15:153–158CrossRef King M, Simpson B (2007) Modern augmentation for glottic insufficiency. Curr Opin Otolaryngol Head Neck Surg 15:153–158CrossRef
35.
go back to reference Hertegard A, Hallen L, Laurent C et al (2004) Cross-linked hyaluronan versus collagen for injection treatment of glottal insufficiency: 2-year follow up. Acta Otolaryngol 124:1208–1214CrossRef Hertegard A, Hallen L, Laurent C et al (2004) Cross-linked hyaluronan versus collagen for injection treatment of glottal insufficiency: 2-year follow up. Acta Otolaryngol 124:1208–1214CrossRef
36.
go back to reference Miaśkiewicz B, Szkiełkowska A, Piłka A, Skarżyński H (2016) Assessment of acoustic characteristic of voice in patients after injection laryngoplasty with hyaluronan. Otolaryngol Pol 70(1):15–23CrossRef Miaśkiewicz B, Szkiełkowska A, Piłka A, Skarżyński H (2016) Assessment of acoustic characteristic of voice in patients after injection laryngoplasty with hyaluronan. Otolaryngol Pol 70(1):15–23CrossRef
37.
go back to reference Hwang CS, Lee HJL, Ha JG et al (2013) Use of pulsed dye laser in the treatment of sulcus vocalis. 148(5):804–809 Hwang CS, Lee HJL, Ha JG et al (2013) Use of pulsed dye laser in the treatment of sulcus vocalis. 148(5):804–809
38.
go back to reference Hirano M, Yoshida T, Tanaka S, Hibi S (1990) Sulcus vocalis: functional aspects. Ann Otol Rhinol Laryngol 99:679–683CrossRef Hirano M, Yoshida T, Tanaka S, Hibi S (1990) Sulcus vocalis: functional aspects. Ann Otol Rhinol Laryngol 99:679–683CrossRef
39.
go back to reference Lim JY, Kim J, Choi SH et al (2009) Sulcus configurations of vocal folds during phonation. Acta Otolaryngol 129:1127–1135CrossRef Lim JY, Kim J, Choi SH et al (2009) Sulcus configurations of vocal folds during phonation. Acta Otolaryngol 129:1127–1135CrossRef
40.
go back to reference Hsiung MW, Pai L, Wang HW (2002) Correlation of Voice Handicap Index and voice laboratory measurements in dysphonic patients. Eur Arch Otorhinolaryngol 259:97–99CrossRef Hsiung MW, Pai L, Wang HW (2002) Correlation of Voice Handicap Index and voice laboratory measurements in dysphonic patients. Eur Arch Otorhinolaryngol 259:97–99CrossRef
41.
go back to reference Wheeler KM, Collins SP, Sapienza CM (2006) The relationship between VHI scores and specific acoustic measures of mildly disordered voice production. J Voice 20(2):308–317CrossRef Wheeler KM, Collins SP, Sapienza CM (2006) The relationship between VHI scores and specific acoustic measures of mildly disordered voice production. J Voice 20(2):308–317CrossRef
42.
go back to reference Woisard V, Bodin S, Yardeni E, Puech M (2007) The Voice Handicap Index: correlation between subjective patient response and quantitative assessment of voice. J Voice 21(5):623–631CrossRef Woisard V, Bodin S, Yardeni E, Puech M (2007) The Voice Handicap Index: correlation between subjective patient response and quantitative assessment of voice. J Voice 21(5):623–631CrossRef
Metadata
Title
Pathological sulcus vocalis: treatment approaches and voice outcomes in 36 patients
Authors
Beata Miaśkiewicz
Agata Szkiełkowska
Elżbieta Gos
Aleksandra Panasiewicz
Elżbieta Włodarczyk
Piotr H. Skarżyński
Publication date
01-11-2018
Publisher
Springer Berlin Heidelberg
Published in
European Archives of Oto-Rhino-Laryngology / Issue 11/2018
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-018-5040-2

Other articles of this Issue 11/2018

European Archives of Oto-Rhino-Laryngology 11/2018 Go to the issue