Summary about Disease
Vocal cord sulcus is a structural abnormality of the vocal cord, characterized by a groove or furrow (sulcus) that runs along the length of the vocal fold. This groove affects the vibratory function of the vocal cord, leading to voice problems. It can be unilateral (affecting one vocal cord) or bilateral (affecting both vocal cords). There are two main types: sulcus vergetures (a shallow groove) and sulcus vocalis (a deeper, more defined groove). This condition can be congenital (present at birth) or acquired.
Symptoms
The primary symptom is hoarseness or a breathy voice. Other symptoms may include:
Voice fatigue (voice tires easily)
Reduced vocal range
Difficulty projecting the voice
Vocal instability or tremor
Globus sensation (feeling of a lump in the throat)
Causes
The exact cause is not fully understood, but potential causes include:
Congenital: Present at birth due to developmental abnormalities during vocal cord formation.
Acquired: Possibly related to vocal trauma, infection, or rupture of a cyst on the vocal cord.
Possible association: Some theories suggest it could be related to epithelial rupture of the vocal folds and subsequent scarring.
Medicine Used
There is no specific medicine that can cure vocal cord sulcus because it is a structural abnormality. However, medication might be used to manage secondary symptoms.
Mucolytics: To thin mucus and improve vocal cord lubrication.
Proton pump inhibitors (PPIs): If reflux is a contributing factor.
Botulinum Toxin (Botox): In rare cases, to address muscle tension dysphonia that may be associated with the condition.
Is Communicable
No, vocal cord sulcus is not a communicable disease. It is not contagious and cannot be spread from person to person.
Precautions
While there are no specific precautions to prevent congenital sulcus, the following can help manage symptoms and prevent acquired cases:
Good vocal hygiene: Avoid vocal abuse (excessive talking, yelling, singing incorrectly)
Hydration: Drink plenty of water to keep vocal cords lubricated.
Avoid irritants: Limit exposure to smoke, allergens, and pollutants.
Voice therapy: To learn proper vocal techniques and prevent strain.
Treat reflux: Manage gastroesophageal reflux disease (GERD) if present.
How long does an outbreak last?
Vocal cord sulcus is not an "outbreak" type of condition. It is a chronic condition. The symptoms are persistent and can fluctuate in severity over time, but they do not resolve on their own without management.
How is it diagnosed?
Diagnosis typically involves:
Medical history and voice assessment: Description of symptoms and vocal habits.
Laryngoscopy: Examination of the vocal cords using a flexible or rigid endoscope. This allows visualization of the sulcus.
Stroboscopy: A specialized laryngoscopy technique that uses a strobe light to visualize the vibratory pattern of the vocal cords. This helps assess the impact of the sulcus on vocal cord function.
Acoustic analysis: Objective measurements of voice parameters (e.g., pitch, loudness, quality) to quantify the severity of the voice problem.
Timeline of Symptoms
The onset of symptoms can vary depending on the cause and severity of the sulcus.
Congenital: Symptoms may be present from early childhood, often noticed when the child begins to speak.
Acquired: Symptoms may develop gradually or suddenly after a vocal event (e.g., screaming, singing). The symptoms usually persist chronically unless intervention is performed. The severity of symptoms can change over time, and some days are worse than others depending on vocal use and general health.
Important Considerations
Voice therapy: Although it cannot eliminate the sulcus, voice therapy is an important component of treatment. It can help patients optimize their vocal technique, reduce strain, and improve voice quality.
Surgery: Surgical interventions, such as medialization laryngoplasty, fat injection, or vocal fold augmentation, are considered in some cases to improve vocal cord closure and vibration. The type of surgery will depend on the severity and type of sulcus.
Patient expectations: Managing vocal cord sulcus requires realistic expectations. Treatment aims to improve voice quality and function but may not restore the voice to normal.
Multidisciplinary approach: Management often involves collaboration between an otolaryngologist (ENT doctor), a speech-language pathologist (voice therapist), and potentially other specialists.