Direct Vocal Fold Testosterone Injection for Treatment of Sulcus Vocalis: A Case Report

This case report describes the use of targeted vocal fold testosterone injection as a novel, minimally invasive treatment for sulcus vocalis in a 28-year-old cisgender male with long-standing voice difficulties unresponsive to conventional therapies. He underwent two intramuscular testosterone injections into the thyroarytenoid muscle. Post-treatment, he demonstrated significant vocal improvements, including enhanced glottal competence, increased phonation time, and improved patient-reported outcomes, suggesting that androgen receptor stimulation may promote vocal fold remodeling as a potential alternative to surgical intervention.