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©2013 UpToDate ® Print Email Abnormal larynx examples A) Photograph shows grade 1+ vocal fold edema. B) Grade 2+ vocal fold edema virtually always represents pseudosulcus vocalis. C) Pseudosulcus vocalis is seen on the right and some sessile changes on the left. The sessile changes are characteristic of grade 3+ vocal fold edema. D) Polypoid degeneration is graded as 4+ vocal fold edema. All four of these views also show partial or complete ventricular obliteration and various degrees of posterior commissure hypertrophy. Reproduced with permission from: Belafsky, P, Postma, G, Amin, M, Koufman, J. Symptoms and findings of laryngopharyngeal reflux. Ear Nose Throat J 2002; 81(9 Suppl 2):10. Copyright © 2002 Ear, Nose, and Throat Journal.