Sulcus vocalis concealed by a hemorrhagic polyp.

A 37-year-old woman, a secretary, had developed hoarseness without an inciting event approximately 4 months prior to her initial clinical examination at our center. During the laryngeal examination, we observed a polyp on the free edge of the right vocal fold along with evidence of a recent right vocal fold hemorrhage.

The patient was initially managed with voice therapy. Following therapy, a repeat laryngeal examination revealed that the hemorrhage had resolved but the polyp still remained. The patient underwent suspension microlaaryn-goscopy, which revealed that the hemorrhagic polyp had arisen from the upper lip of a large sulcus vocalis (figure 1). The base of the lesion was transected with microlaryngeal scissors. The contact lesion and associated vasculature on the contralateral vocal fold were left undisturbed. After excision of the hemorrhagic polyp, the full extent of the sulcus vocalis could be appreciated (figure 2). This patient will require a secondary reconstruction of the sulcus vocalis to optimize her vocal function.