Sulcus Vocalis: Clinical and Surgical Aspects

Objectives: To analyze clinical, vocal, and videolaryngoscopic parameters, as well as the treatments of patients with sulcus vocalis.

Methods: This is an observational study. The medical records of patients diagnosed with sulcus vocalis (type II or III) were selected and demographic data, vocal symptoms, videolaryngostroboscopies, vocal analyses (perceptual and acoustic), and maximum phonation time (MPT) were collected. The vocal parameters of patients who underwent microsurgery to treat the sulcus were compared before and after surgery.

Results: Exactly 109 patients were diagnosed with sulcus; however, only 60 completed the inclusion criteria (39 women and 21 men), with a mean age of 45 years. Hoarseness and vocal fatigue were reported in 100% and 88% of cases, respectively. Laryngoscopy indicated a type II sulcus (90%), type III sulcus (10%), and an association of the sulcus with other benign lesions (23%), especially polyps. Perceptual evaluations indicated mild to moderate dysphonia, roughness and breathiness of the voice, mean MPT of 10 seconds, and high values of jitter, pitch perturbation coefficient, and soft phonation index (SPI). Twenty-two patients (14 women and 8 men) underwent sulcus microsurgery. The surgery promoted a decrease in the GRBAS scores, an increase in the MPT, and a decrease in the SPI; however, other acoustic parameters remained unchanged.

Conclusions: Patients with sulcus vocalis had mild to moderate dysphonia, in addition to voice roughness and breathiness and elevated fundamental frequency. Surgical treatment improved vocal parameters but maintained some degree of dysphonia, indicating incomplete restoration of vocal qualities.