Voice and Videostroboscopic Analysis of Sulcus Vocalis after Slicing Mucosa Surgical Technique

Han, Kyung Yuhl; Nam, Soon Yuhl

Abstract

BACKGROUND AND OBJECTIVES: Sulcus vocalis is not an uncommon cause of breathy dysphonia. One of the treatment options may be the slicing mucosa surgical technique which has been met with some criticism. This study was designed to investigate the efficiency of slicing mucosa surgical technique for the treatment of sulcus vocalis with voice and stroboscopic analysis. MATERIALS AND METHODS: In 18 sulcus vocalis patients (10 males, 8 females), the slicing mucosa surgical technique was performed followed by voice therapy for 4 weeks. Postoperative parameters of perceptual analysis, acoustic analysis, aerodynamic study, and videostroboscopy after 6 months were compared with those of preoperative results.
RESULTS
In the perceptual analysis, the rough component of dysphonia was improved in 71.4% of patients, whereas the breathy component was improved in 25.0% of patients. Fundamental frequency, jitter, shimmer of acoustic analysis were significantly improved, but MPT, MFR of aerodynamic study showed no changes. There was anatomical evidences of sulcus in 4 of 18 patients postoperatively. Videostroboscopy mucosa waves during phonation showed improvement in 72.2% of patients, but glottic insufficiencies showed improvement only in 38.9%.
CONCLUSION
The results of this study indicate that the slicing mucosa surgical technique is effective in improving the anatomical abnormality and stiffness of vocal cord mucosa, but unsatisfactory in improving glottic insufficiency of sulcus vocalis. It may be helpful to develop a new or an additional technique that can simultaneously promote improved rnucosa vibration and glottic closure.