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In sulcus vocalis, either the superficial layer of the lamina propria is absent altogether (usually causing severe dysphonia and requiring considerable vocal effort), or a portion of the epithelium invaginates through the superficial layer of the lamina propria and adheres to the vocal ligament.
5) When used, collagen is injected into the region of the vocal ligament and appears particularly appropriate for treating limited vocal fold scarring.
True sulcus vocalis results from scarring of the surface epithelium to the underlying vocal ligament as a result of loss or absence of the loose layer in between, known as the superficial lamina propria.
The primary pathology seen in this image is the right vocal fold polyp, but a slight scalloping of the vocal ligament at the base of the polyp can also be seen.
However, the lesion in our patient represented an area of scar with a loss of the superficial lamina propria in a discrete area, leading to the adherence of the epithelium to the vocal ligament.
Strobovideolaryngoscopy detected a large mass on the left vocal fold that extended from the vibratory margin to deep in the vocal ligament (figure).
A vocal ligament is not yet developed to allow tension to be applied along the length of the vocal fold for pitch control.