Efficacy of voice therapy for patients with vocal fold scarring and sulcus vocalis

Vocal fold scarring and sulcus vocalis significantly increase stiffness of the mucosal wave of the vocal folds. The dysphonia caused by vocal fold scarring and sulcus vocalis is often severe and difficult to treat. We report here three cases with vocal fold scarring and sulcus vocalis that were successfully treated by voice therapy. Two cases had been initially treated by local injection of basic fibroblast growth factor (bFGF) into the vocal folds. The other case had no history of prior treatment. Stroboscopic examination showed reduction of the mucosal wave of amplitude, a spindle-shaped glottal gap and hyperfunction in all patients. They underwent voice therapy consisting of exercises designed to modify vocal misuse and increase vocal fold flexibility, such as trill exercises and Vocal Function Exercise (VFE). Examination at the end of voice therapy showed remarkable improvement of voice. Stroboscopy showed mobile, less stiff vocal folds with excellent amplitude and mucosal wave. These results indicate that voice therapy can help improve vocal function in cases with vocal fold scarring and sulcus vocalis.