Sulcus vocalis is a condition that causes a chronic, ever-present hoarse voice—it can be worse on certain days, but it means that you never quite sound the same as someone with a “normal” voice.
Patients experience hoarseness, pitch disorders, poor volume, inadequate projection, and vocal fatigue. These symptoms are caused by a structural problem in the vocal cords that causes the cords to become bowed. The bowing makes a gap between the cords, which interferes with the cords’ ability to close properly. The resultant incomplete contact, abnormal vibration, altered sound quality, and diminished sound volume lead to an overall decrease in vocal performance.
Many physicians believe that sulcus vocalis is caused by a thinning or absence of a layer of the vocal cord called the superficial lamina propria. The affected cord becomes misshapen and indented. This indentation or “furrow” is called a sulcus. Whether this condition is genetic, developmental, or the result of trauma is a matter of much debate. Nonetheless, there is no debating the fact that while the symptoms may wax and wane, the condition is lifelong.
Treatment of sulcus vocalis usually involves a procedure to close the gap and restore proper vocal cord contact. Attempts to remove the sulcus have been less than ideal as scar tissue occurs in the healing process, and this often vibrates less than the original sulcus. Grafts from neighboring tissues to try to replace the missing tissues of the superficial lamina propria have also had mixed results. Filler injections used to close the gap caused by the sulcus vocalis seem to provide the most satisfactory results, but since the filler is temporary, repeat injections may be necessary.
Sulcus vocalis can be challenging to diagnose. That’s why an otolaryngologist (ear, nose & throat physician/ surgeon) like Dr. Yagoda, who specializes in care of the professional voice, can help. She has the knowledge and tools to diagnose and treat this subtle condition. If you or someone you know has hoarseness, breathiness, or exertion on phonation, call Dr. Yagoda for a comprehensive voice consultation in her New York City/ NYC/ Manhattan office.