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Sulcus vocalis has usually been thought of as an absence of the lamina propria, a layer of the vocal fold that is essential to vibration. This examination of material removed at surgery for sulcus shows that inflammation of another layer, the epithelium, is much more prominent. This has important implications for surgery, and suggests that implants to replace the lamina propria may not be nearly as important as careful removal of the sulcus itself.
