Histopathological Characteristics of Sulcus Vocalis

Abstract

Objective. To describe the frequency of sulcus vocalis in a population and to establish its histopathological properties. Study Design. A cadaver study. Setting. Istanbul Training and Research Hospital and Ministry of Justice National Forensic Institute. Subjects and Methods. One hundred (21 women, 79 men) fresh cadaver larynges were examined. Two hundred vocal folds were coronally sectioned and examined by light microscopy. Sulcus types, depths, degree of fibrosis in Reinke space, basement membrane thickness, and perisulcus degeneration were determined. Results. Sulcus vocalis was found in 39 of 100 cases (39%), with a male preponderance of 41.8% compared with women at 28.6%. Twenty-one (54%) cases had unilateral and 18 (46%) cases had bilateral sulcus. Among 200 vocal folds, 57 had sulcus (28%). A total of 21 sulcus cases were type 1 (37%), 18 were type 2 (31.5%), and the remaining 18 cases were type 3 (31.5%). Of the 39 (30.7%) sulcus cases, 12 were confirmed by histopathological examination, although they looked morphologically normal following macroscopic evaluation. Vocal ligament involvement was found in 14 cases with type 2 (78%) and in 15 cases with type 3 sulcus (83%). Conclusion. Sulcus vocalis is a common pathology in the population and can be observed at all ages. The accuracy of diagnosis seems to depend on the measurement of the sulcus depth and the histological characteristics. For this reason, tools and strategies should be established in living subjects for effective management of this challenging disorder.