Author(s)
Nupur Kapoor Nerurkar, MBBS, DORL, MS (ENT)
Lucian Sulica, MD
Markus M. Hess, MD, PhD
Daniel Novakovic, MBBS, MPH
Meghna Shah, DLO
Alexandra Li, BS
Zhou Hao Leong, MBBS, MRCSEd, Mmed(ORL)
Affiliation(s)
Bombay Hospital and Medical Research Center; Weill Cornell Medical College; Medical Voice Center; University of Syndey;
Abstract:
Background: The occurrence of sulcus vergeture (SVE) in family groups and preponderance of reports from specific geographical areas suggests a hereditary etiology. The primary objective of our study is to audit the possibility of a geographical variability in the demographics of SVE in comparison to sulcus vocalis (SVO). The secondary objective is to study the patterns of presentation and variability in treatment.
Methods: Following ethics clearance, a 3-year retrospective review of the demographics of vocal fold sulcus was conducted at voice centres in India, USA, Germany and Australia. SVE and SVO cases were noted with details of associated lesions, sex, race, performers, age and treatment given. The denominator was the number of benign mucosal glottic lesions.
Results: Of a total 351 cases of sulcus, 239 (68%) were SVE, with associated lesions in 56% (47% in SVO). A total of 50/239 (21%) SVE and 56/112 (50%) SVO were found in vocal performers (p<.00001) . A total of 160/239 (67%) SVE and 64/112 (57%) SVO were found in men. Sulcus of both types made up 20% of benign lesions in Sydney and 17% in Mumbai which were significantly (p<.00001) higher than New York (4%) and Germany (3.5%). SVE comprised 82% of cases (Mumbai), 72% (Sydney), 70% (New York) and 8.5% (Germany) with a significantly higher geographical variability than SVO.
Conclusion: Both SVO and SVE were found predominantly in men. SVO was significantly more prevalent in performers, suggesting phonotrauma in its formation. SVE showed significant geographical variation, suggesting regional variation in its prevalence, supporting heredity in its formation.