Scar and Sulcus Vocalis

What is a scar/sulcus?

A scar/sulcus of the vocal fold is different than a scar anywhere else on your body. Scarring of the vocal fold means that the mucosa (covering of the vocal fold) is tethered to the underlying tissue and cannot vibrate freely. Vocal fold sulcus/scar is a disruption to the Reinke’s layer of the vocal folds (or the superficial lamina propria) which is meant to allow for free motion of the overlying mucosa.

What causes a scar/sulcus?

Scar/sulcus can occur in many ways. It can result from:

  • vocal fold lesions that have been present for a long time and have grown into deeper tissue
  • surgery of the vocal folds
  • repeated hemorrhaging of the vocal folds
  • radiation used to treat cancer
  • other repeated irritation/inflammation/trauma to the vocal folds

What are the symptoms of a scar/sulcus?

A patient with a scar/sulcus will have irregular vibration of the vocal folds, and will therefore present with hoarseness, breathiness, and increased effort to produce voice. Severity of these symptoms can vary greatly depending on the length and depth of the scar/sulcus, and the way each individual’s vocal folds react to or vibrate around the scar/sulcus.

How is a scar/sulcus treated?

Repairing a scar/sulcus once it has already occurred is very difficult. There are some surgical options which can occasionally benefit a patient with a scar/sulcus (which can be discussed with a laryngologist). Occasionally, voice therapy can be beneficial in order to improve voicing patterns and provide more efficient speaking techniques to aid with quality of life.