COEXISTENCE OF BILATERAL SULCUS VERGETURE AND BILATERAL FIBROUS MASS OF THE VOCAL FOLDS: CASE REPORT
Beata Miaskiewicz, Agata Szkielkowska
(Audiology and Phoniatrics Clinic, World Hearing Center of the Institute of Physiology and Pathology of Hearing, Warszawa/Kajetany, Poland)
JHS 2015; 5(3): 47-51
This study presents the case of a 32-year old woman who presented with severe dysphonia. She had experienced voice problems since childhood.
CASE REPORT: The patient underwent otolaryngological and phoniatric examination including videolaryngostroboscopy (VLS), perceptual evaluation (GRBAS scale), and acoustic analysis of voice (MDVP software). Microsurgery was performed using a CO2 Acupulse laser (Lumenis) with AcuBlade micromanipulator.
VLS revealed glottal incompetence, an intracordal mass on the right vocal fold, and capillary ectasia on the superior surface of the right vocal fold. Atrophy was seen along the free edge of the left vocal fold. GRBAS and MDVP revealed significant voice disturbances. The patient was referred for direct microlaryngoscopy. Initial inspection of the vocal folds showed bilateral intracordal mass and sulcus vergeture. Using a microflap technique the fibrous mass was removed. For the sulcus vergeture a surgical technique based on a concept by Cornut and Bouchayer and modified by Remacle was used. Complementary hyaluronic acid (Surgiderm 24XP) was injected to correct the left vocal fold volume. Stroboscopic evaluation performed 3 months postoperatively showed significant improvement of glottis closure and vibratory parameters. Perceptual and objective voice assessment revealed improvement in the acoustic structure of the voice after surgery.
CONCLUSIONS: Coexistence of bilateral sulcus vergeture and bilateral fibrous mass is a very rare occurrence. The preoperative diagnosis is often not obvious. Severe voice disturbances make surgery the first treatment option in such cases.
Keywords: Aphonia, dysphonia, Speech Disorders