Abstract
One hundred and fourteen cases which presented a furrow on the vocal cord (s) were clinically investigated. In eighty-two of the entire cases the furrow was the only or the most dominant pathology whereas the other thirty-two cases presented some other dominant pathology, such as polyp, carcinoma, inflammation, paralysis, and so on. Among the former eighty-two cases, voice disorder was the chief complaint in seventy-five cases (sulcus vocalis). In addition to the clinical investigations, vocal cords of five autopsy cases and a laryngectomy case in which a clear furrow was found was histologically investigated. The results lead us to the following conclusions:
1) The onset of voice disorder, mostly hoarseness, is at very young ages, at the puberty or at advanced ages.
2) The typical findings of sulcus vocalis consist of existence of a furrow near the edge of the bilateral vocal cords extending from the vocal process to the anterior commissure, a concave edge of the vocal cords during respiration, incomplete glottic closure during phonation, and excessive adduction of the false cords during phonation.
3) The sulcus is located in the region covered with squamous epithelium and in the superficial layer of the lamina propria. The epithelium in the sulcus is occasionally thickened. Collagenous fibers are often increased and capillaries are poor underneath the sulcus.
4) Etiologic factors of sulcus vocalis do not seem singular. Congenital deformity, some factors related to puberty, residue of repeated inflammation, and senile changes are the possible causes of sulcus vocalis.
5) In about one third of the cases, excessive abuse of air is found during phonation.
6) Vibration is more or less disturbed at the sulcus during phonation. This results from an increase in stiffness of the tissue arround the sulcus.
7) Intracordal injection is effective for mild cases but not so effective for cases with a deep and wide furrow. Sulcusectomy may be effective to replace the stiffened tissue with more pliant tissue.
