Sulcus vocalis in spasmodic dysphonia-A retrospective study.

Area of Science:

• Laryngology
• Neurology
• Speech Pathology

Background:

• Spasmodic dysphonia (SD) is a neurological voice disorder affecting laryngeal muscles, with current treatments like Botulinum Toxin injections being less effective for Abductor SD (ABSD).
• Sulcus vocalis is a vocal fold condition characterized by breathiness and hypophonia, occasionally observed in SD patients during clinical evaluations.

Purpose of the Study:

• To investigate the potential association between vocal fold sulcus and two specific groups of Spasmodic Dysphonia: Adductor SD (ADSD) and Abductor SD (ABSD) combined with Mixed SD.

Main Methods:

• A retrospective review of 106 Spasmodic Dysphonia patients diagnosed between January 2016 and September 2019.
• Patients were categorized into ADSD and a combined group of ABSD/Mixed SD.
• Presence of vocal fold sulcus was assessed via flexible videostroboscopy, with Odds Ratio used for statistical analysis.

Main Results:

• Vocal fold sulcus was identified in 5/84 ADSD patients, 4/10 ABSD patients, and 3/12 Mixed SD patients.
• A statistically significant association was found for the ABSD and Mixed SD group, with an Odds Ratio of 7.37 (C.I. = 2.063-26.35).

Conclusions:

• A significant association exists between vocal fold sulcus and Spasmodic Dysphonia cases with an abductor component (ABSD and Mixed SD).
• Potential explanations include asymmetrical muscle stimulation in SD or sulcus presence influencing sensory feedback.
• Further research is recommended to explore these hypotheses and evaluate treatments for ABSD with sulcus.