Unraveling Sulcus Vergeture (Type II): Demographic and Clinical Characteristics

Multiple studies have addressed pathological sulcus (types II and III) collectively; however, it is important to note that type II and III represent distinct entities rather than varying degrees of the same disease. This study aims to focus on the frequency, demographic features, clinical presentation, and typical examination results of patients with type II sulcus (sulcus vergeture).

An analysis was performed on the data of 3023 patients who were admitted to the voice and swallowing outpatient clinic due to dysphonia. Videostroboscopies of 3023 patients were analyzed to assess for vocal fold (VF) diseases, particularly the presence of a pathological sulcus (types II and III). After a total of 56 patients with type II sulcus were identified, their videostroboscopy findings and past medical records were reviewed.

The detection rate of type II sulcus in our patient cohort was 18 per 1000. There were 30 females and 26 males. All of our patients noted hoarseness as their primary symptom. The additional symptoms included a breathy voice (53.5%), vocal fatigue (67.8%), husky voice (66%), high pitch disturbance (42.8%), vocal fluctuation (26.7%), and vocal strain (35.7%). The most common videostroboscopic findings included decreased mucosal wave (100%), bilateral groove (89.2%), supraglottic hyperactivity (75%), and glottic gap (71.4%).

Familial history of dysphonia, the presence of the groove along the membranous VF rather than a part of the VF, bilaterality of the lesion, the absence of perilesional inflammation, and complaints of a high-pitched disturbance (especially in male patients) are characteristics of type II sulcus that distinguish it from type III sulcus.