Ventricular dysphonia: a case of false vocal fold mucosal traveling wave.

Ventricular dysphonia, also known as dysphonia plicae ventricularis, is a disorder of speech in which the ventricular folds (false vocal folds, FVFs) participate pathologically in phonation. 1,2 Although the first anatomic illustrations of the false folds were done in 1775 by Santorini ,3 their role in phonation was not completely understood. In 1860, 6 years after the introduction of the laryngeal mirror by Garcia, J.N. Czermak was the first to recognize that involvement of the false folds in phonation is a pathological phenomenon.’ The ventricular folds are composed of soft and elastic connective tissue containing fat cells with scattered muscle fibers from the thyroarytenoideous (TA) muscle.2 They are lined by pseudostratified ciliated columnar epithelium and tubuloacinar glands.4,5 Under normal circumstances, these folds adduct with the arytenoids and assist in laryngeal closure. However, they do not participate in normal voice production1 In some pathological states, the false folds adduct before the true vocal folds (TVFs) and hence hamper normal voice production. This pattern is caused by either underactivity of the TVFs or overactivity of the FVFS.~ However, in some other reports, it has been stated that during laryngeal examination of a patient with ventricular phonation, the FVFs adduct either immediately before or after the adduction of TVFs.” The vocal quality in ventricular dysphonia has been described as a rough, weak, breathy,