New operation for sulcus vocalis--laser vaporization of the sulcus with fat injection

Abstract:  Although several treatments for sulcus vocalis have been reported, the condition continues to be known as an extremely intractable vocal disorder even now. We report the good outcome of a new treatment for sulcus vocalis. The operation was performed under intubated general anesthesia. We aspireted abdominal fat using an 18-gauge needle and a 20 = cc disposal syringe first. After collection of the fat, laryngomicrosurgery and laser vaporization of the sulcus bilaterally was performed using a KTP laser. Then, the collected fat was injected into the thyroarytenoid muscle bilaterally (about 1cc on each side). Seven patients underwent this surgery. The voice, as evaluated auditorily, improved in all the cases and the maximum phonation time increased in 6 of the 7 cases. We attribute the vocal improvement to the formation of new free edges of the vocal folds after this surgery.