Vocal cord bowing is a descriptive term to specify that the vocal cords are not matching in a straight line, with only a thin dark line between them at the moment of pre-phonation. Instead, the cords become gently concave or bowed outwards. At the moment of pre-phonation, there is a wider, oval slit between the cords.
Bowing can be physiologic, asymptomatic, and a genetic “given.” In this physiologic type, the bowing will be subtle to mild and there will be good vibratory pattern. When moderate or severe, bowing may more likely be the result of aging, vocal disuse, Parkinson’s disease, or other conditions. Moderate and severe bowing correlate with a degree of vocal cord atrophy and the vibratory pattern can be more flaccid. The voice tends to have a soft-edged quality, a little higher in pitch than normal, and can fade with use. Voice building is the primary treatment, but very occasionally severe bowing is treated with bilateral vocal cord implants.
Photos:
Vocal Cord Bowing
Wide lateral excursions (1 of 4)
Wide lateral excursions (1 of 4)
Anterior cords are more flaccid (2 of 4)
Anterior cords are more flaccid (2 of 4)
Vocal cord bowing (3 of 4)
Vocal cord bowing (3 of 4)
Vocal cord bowing (4 of 4)
Vocal cord bowing (4 of 4)
Glottic gap (1 of 3)
Glottic gap (1 of 3)
Vibratory blur (2 of 3)
Vibratory blur (2 of 3)
Wide lateral excursion (3 of 3)
Wide lateral excursion (3 of 3)
Vocal cord bowing (1 of 2)
Vocal cord bowing (1 of 2)
Vocal cord bowing (2 of 2)
Vocal cord bowing (2 of 2)
Vocal cord bowing (1 of 4)
Vocal cord bowing (1 of 4)
Vocal cord bowing (2 of 4)
Vocal cord bowing (2 of 4)
Cords do not close (3 of 4)
Cords do not close (3 of 4)
Vocal cords only come in near contact (4 of 4)
Vocal cords only come in near contact (4 of 4)
Oval gap during prephonatory instant (1 of 4)
Oval gap during prephonatory instant (1 of 4)
Vocal cord bowing (2 of 4)
Vocal cord bowing (2 of 4)
Anterior flaccidity (3 of 4)
Anterior flaccidity (3 of 4)
Vocal cord bowing (4 of 4)
Vocal cord bowing (4 of 4)
Vocal cord bowing (1 of 5)
Vocal cord bowing (1 of 5)
Musculomembranous are bowing (2 of 5)
Musculomembranous are bowing (2 of 5)
Elliptical gap (3 of 5)
Elliptical gap (3 of 5)
Vocal cord bowing (4 of 5)
Vocal cord bowing (4 of 5)
Vocal cord bowing (5 of 5)
Vocal cord bowing (5 of 5)
Bowing of vocal cords and effect of pitch
Weak voice (1 of 8)
Weak voice (1 of 8)
Phonatory view (2 of 8)
Phonatory view (2 of 8)
"Closed" phase (4 of 8)
"Closed" phase (4 of 8)
B3, open phase (5 of 8)
B3, open phase (5 of 8)
D3, open phase (3 of 8)
D3, open phase (3 of 8)
B3, closed phase (6 of 8)
B3, closed phase (6 of 8)
Bb4, open phase (7 of 8)
Bb4, open phase (7 of 8)
Bb4, closed phase (8 of 8)
Bb4, closed phase (8 of 8)
Four views of vocal cord bowing in the same person
Bowed vocal cords (1 of 8)
Bowed vocal cords (1 of 8)
Prephonatory view (2 of 8)
Prephonatory view (2 of 8)
Open phase (3 of 8)
Open phase (3 of 8)
Gravel voice (4 of 8)
Gravel voice (4 of 8)
Reduced flaccidity (5 of 8)
Reduced flaccidity (5 of 8)
Closed phase (6 of 8)
Closed phase (6 of 8)
Falsetto, open phase (7 of 8)
Falsetto, open phase (7 of 8)
Falsetto, closed phase (8 of 8)
Falsetto, closed phase (8 of 8)
Red herring capillary ectasia and mucosal injuries
Ectatic capillary (1 of 4)
Ectatic capillary (1 of 4)
Ectatic capillary, narrow band light (2 of 4)
Ectatic capillary, narrow band light (2 of 4)
Margin swelling (3 of 4)
Margin swelling (3 of 4)
Bowing, atrophy, and flaccidity (4 of 4)
Bowing, atrophy, and flaccidity (4 of 4)
Glottic furrow—not just bowing and not glottic sulcus
Bowing vocal cords with furrows (1 of 4)
Bowing vocal cords with furrows (1 of 4)
Closed phase (2 of 4)
Closed phase (2 of 4)
Open phase (3 of 4)
Open phase (3 of 4)
Lower pitch reveals furrow (4 of 4)
Lower pitch reveals furrow (4 of 4)
Voice Building:
Voice Building (shorter version):