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EDITORIAL
Year : 2015  |  Volume : 5  |  Issue : 1  |  Page : 1

Sulcus vocalis: Solving the puzzle


Department of ENT, Command Hospital, Chandimandir, India

Date of Web Publication17-Dec-2015

Correspondence Address:
Rakesh Datta
Department of ENT, Command Hospital, Chandimandir
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2230-9748.172087

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How to cite this article:
Datta R. Sulcus vocalis: Solving the puzzle. J Laryngol Voice 2015;5:1

How to cite this URL:
Datta R. Sulcus vocalis: Solving the puzzle. J Laryngol Voice [serial online] 2015 [cited 2019 Aug 25];5:1. Available from: http://www.laryngologyandvoice.org/text.asp?2015/5/1/1/172087

As the field of laryngology has evolved, newer diagnostic tools have enabled the scientific community to look afresh at disorders of the voice. Newer diagnoses have has been made to explain the symptoms of dysphonia and globus sensation. One such neo-diagnosis is "sulcus vocalis," a disorder characterized by a linear furrow on the free edge of the vocal fold. [1] It has further been subdivided into various types based on the depth of the groove and its attachment to the underlying vocal ligament. The primary tool available to the laryngologist to make this diagnosis and classify it further into physiological and pathological varieties is video laryngostroboscopy. [2] Interestingly, sulcus vocalis has increasingly been attributed as a cause of dysphonia in a growing percentage of patients largely due to the availability of better examination tools such as microlaryngeal examination and video laryngostroboscopy. However, making the diagnosis and labelling it as a disease is not an open and shut case. First, the very etiopathogenesis is unclear with theories ranging from genetic to acquired causes. Sulci have been demonstrated in families and also believed to develop the following inflammatory processes. Moreover, many people without a voice complaint have the presence of sulci questioning, it as a cause of dysphonia. [3] It is also not clear whether the diagnosis is being made with sufficient accuracy. A study comparing the diagnostic yield of microlaryngoscopic examination compared to stroboscopy indicate a more than 40% increase in diagnosis using the former technique. [4] This highlights the shortcomings of videostroboscopy as the primary tool to make a diagnosis.

The lack of a precise parameter to diagnose the condition and to differentiate it from being purely physiological and pathological is evident, and a group of researchers at the All India Institute of Speech and Hearing at Mysore have tried to address this important issue using electroglottography as a diagnostic tool. [5] The attempt is praiseworthy though despite the findings brought out by the research, the differential diagnosis will still remain uncertain. It is, therefore, important that such studies are done to generate more data and attempt to solve this riddle. Needless to say, the final words have not been said, and the mystery of sulcus vocalis will remain under wraps.

 
   References Top

1.
Giovanni A, Chanteret C, Lagier A. Sulcus vocalis: A review. Eur Arch Otorhinolaryngol 2007;264:337-44.  Back to cited text no. 1
    
2.
Sulica L. Laryngoscopy, stroboscopy and other tools for the evaluation of voice disorders. Otolaryngol Clin North Am 2013;46:21-30.  Back to cited text no. 2
    
3.
Selleck AM, Moore JE, Rutt AL, Hu A, Sataloff RT. Sulcus vocalis (Type III): Prevalence and strobovideolaryngoscopy characteristics. J Voice 2015;29:507-11.  Back to cited text no. 3
    
4.
Akbulut S, Altintas H, Oguz H. Videolaryngostroboscopy versus microlaryngoscopy for the diagnosis of benign vocal cord lesions: A prospective clinical study. Eur Arch Otorhinolaryngol 2015;272:131-6.  Back to cited text no. 4
    
5.
Sreedevi N, Pebbili GK, Prakash TK, Bharadwaj SS. Electroglottographic patterns in physiologic and pathologic types of sulcus vocalis. J Laryngol Voice 2015;5:2-6.  Back to cited text no. 5
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