Sulcus Vocalis or Vocal Fold Scarring

What is it?
Scarring of the vocal folds can be very problematic to voice production, especially if the scar damages the fine, layered microstructure.  The superficial lamina propria, which is the layer just under the surface of the vocal folds, is responsible for voice production and may be thin or absent if there is scarring.  Sulcus vocalis is a disorder where there is complete loss of the superficial lamina propria.  Voices are often raspy and strained because the vocal fold is not soft and cannot generate the normal wave responsible for voice production.

How is it treated?
Vocal fold scar is very difficult to treat, and treatments vary depending on the nature and extent of scarring.  Some patients can optimize their voices with therapy.  Some patients may improve with expansion of the superficial lamina propria with an injection, whereas others may attempt to undergo scar removal or other reconstructive techniques in the operating room to restore vocal function.