Mucosal bridge of the vocal fold: difficulties in the diagnosis and treatment

Abstract

Summary: Mucosal bridges are rare laryngeal lesions probably of genetic origin. They may cause dysphonia of varying degrees, especially when associated with other laryngeal lesions such as vocal sulci and cysts. Reports on mucosal bridges are rare, and the better treatment is inconclusive.

Aim: To report the authors' experience in 14 cases of mucosal bridge showing details on endoscopic examinations and treatment.

Study design: Retrospective study.

Methods: We reviewed the medical records of 14 patients with a diagnosis of mucosal bridge confirmed by videolaryngostroboscopy and direct laryngoscopy who attended the Outpatient Clinic of Voice Disorders of the Discipline of Otorhinolaryngology, Botucatu Medical School, São Paulo State University, São Paulo. Data collected included information on gender, age, symptoms, time of onset, history of intubation, smoking status, alcohol intake, associated laryngeal lesions, treatment, and GRBAS (grade of hoarseness, roughness, breathiness, asthenia, and stress) scale ratings.

Results: Of 14 patients, 10 were females and four were males. There was a prevalence of adults (n=12), with only two of the patients being younger than 13 years (10 and 13 years). Mucosal bridges showed no correlations with smoking, alcohol intake, or gastroesophageal and sinonasal symptoms. Voice abuse was reported in 50% of the cases that consisted of patients who had high-voice demand occupations. In seven cases, mucosal bridges were associated with other laryngeal lesions, particularly vocal cysts and sulci. All patients who underwent surgery and phonotherapy showed improved vocal quality.

Conclusions: We documented 14 patients with dysphonia caused by mucosal bridge. Promising results were obtained with surgery.