Vocal fold mucosal bridge without sulcus vocalis in a smoker

by Mauro Zernotti, MD, Cristina Jackson-Menaldi, PhD, and Adam D. Rubin, MD | Monday, June 01, 2009

A 35-year-old woman with a 20-pack-year smoking history presented with chronic hoarseness and lowered pitch. Strobovideolaryngoscopy detected a polypoid mass of the right vocal fold; the mass had caused a large contact indentation on the left (figure, A). A slit was discovered between the mass and the lateral aspect of the vocal fold, raising suspicion of a mucosal bridge (figure, B). The patient agreed to stop smoking, was treated aggressively for reflux, and was taken to the operating room for microdirect laryngoscopy.Figure. A: The polypoid mass is seen on initial strobovideolaryngoscopy. B: The slit is seen between the mass and the lateral aspect of the vocal fold. C: Following microflap excision of the right vocal fold residual mass, the patient still has a left contact indentation, but it is clinically insignificantA mucosal bridge was confirmed at surgery. It was filled with Reinke edema. No associated sulcus vocalis or epidermoid cyst was seen, but the subepithelial space of .../continued/

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