A Systematic Review on Surgical Treatments for Sulcus Vocalis and Vocal Fold Scar

Objectives/Hypothesis Vocal fold sulcus and scars are benign vocal fold lesions that present as a challenge to the laryngologist. A number of different surgical techniques have been proposed, aiming at restoring the lamina propria (LP), closing the glottal gap, or both. This study aimed to provide a...

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Bibliographic Details
Published in:The Laryngoscope 2022-04, Vol.132 (4), p.822-830
Main Authors: Medeiros, Nuno, Castro, Maria Eugénia Morais, Lith‐Bijl, Julie Titske, Desuter, Gauthier René Raymond
Format: Article
Language:English
Subjects:
Acoustics
Cicatrix - etiology
Cicatrix - pathology
Cicatrix - surgery
glottal gap
Humans
Laryngeal Muscles - pathology
Laryngoscopy
Larynx
mucosal wave
Stroboscopy
Sulcus vocalis
Surgical techniques
Systematic review
Throat surgery
Vocal Cords - pathology
Vocal Cords - surgery
vocal scar
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Summary:Objectives/Hypothesis Vocal fold sulcus and scars are benign vocal fold lesions that present as a challenge to the laryngologist. A number of different surgical techniques have been proposed, aiming at restoring the lamina propria (LP), closing the glottal gap, or both. This study aimed to provide a systematic review of surgical treatment for sulcus and scar and to propose a new classification for these techniques. Study Design A literature search using MEDLINE and Google Scholar through August 2020. Methods Data on study design were retrieved and outcomes were classified as acoustic, aerodynamic, self‐reported, perceptual, and stroboscopic. Methodological quality was assessed using the MINORs criteria. Each technique was classified as direct, indirect, or combined. Results Our search included 31 studies with a total of 617 patients. Direct techniques included dissection, graft interposition, or LP regeneration/scar degradation while indirect techniques aimed for glottal gap closure. Only one article performed a comparison between different types of techniques and only eight studied the five types of outcomes. No superiority of any technique was noted in our analysis. Self‐reported outcomes were the most frequently improved. Conclusions There seems to not exist a one‐fits‐all treatment for this clinical picture and no clear decision‐making pattern. A recent trend toward sequential approaches, starting with less invasive procedures, can be observed. Laryngoscope, 132:822–830, 2022
ISSN:0023-852X
1531-4995
DOI:10.1002/lary.29665