A degenerative lesion consisting of the empty “pocket” of what was formerly a cyst under the mucosa of the vocal cord. The lips of a glottic sulcus may be seen faintly during laryngeal stroboscopy. Or, vibratory characteristics may suggest this lesion.
A glottic sulcus may be overlooked unless one is familiar with this entity. To paraphrase eminent French laryngeal microsurgeon Dr. Marc Bouchayer, these lesions are diagnosed much more frequently once you know about them than before. At present, aside from having the patient coexist peacefully with this problem via voice therapy and other measures, surgery is the primary treatment modality.
Glottic Sulcus, before and after surgery
Congenital glottic sulcus and bowing, before and after injection
Glottic Sulcus and Glottic Furrow
Glottic Sulcus Operation
Surgical Removal of Glottic Sulcus
Open Cyst or Sulcus?
Sulcus and Segmental Vibration
Open Cyst and Sulcus; Normal and Segmental Vibration
Glottic Furrow—Not Just Bowing and Not Glottic Sulcus
Mottled Vocal Cord Mucosa May Hide Glottic Sulci
A Case That Clearly Shows the Relationship Between Cyst & Sulcus
Nuances of Endotracheal Tube Injury
This woman with high-risk comorbidities of diabetes and obesity, was in ventilated in ICU more than a month for pulmonary complications of Covid-19 infection. She had an orotracheal tube in place for 3.5 weeks, and then a tracheotomy tube was placed. Now at her first visit a year later, she remains tracheotomy-dependent, and is told she has bilateral vocal cord paralysis (disproven in the following photo series).
The plan here is posterior commissuroplasty, followed by placement of a smaller trach tube and a trial of plugging. If plugging is tolerated during the day, she will need a sleep study with it plugged at night, given the tracheomalacia and her obesity.