Immunocytochemical Study of Proteoglycans in Vocal Folds

1996 ◽  
Vol 105 (1) ◽  
pp. 6-11 ◽  
Author(s):  
Agnieszka S. Pawlak ◽  
Elizabeth Hammond ◽  
Thomas Hammond ◽  
Steven D. Gray
Keyword(s):  
Chondroitin Sulfate ◽  
Lamina Propria ◽  
Vocal Fold ◽  
Keratan Sulfate ◽  
Vocal Folds ◽  
Basement Membrane Zone ◽  
Immunocytochemical Study ◽  
Frozen Sections ◽  
Intense Staining ◽  
Immunocytochemical Techniques

We evaluated the proteoglycan composition of normal vocal folds using immunocytochemical techniques. Frozen sections of 14 normal cadaveric vocal folds were obtained within 12 hours of death and sectioned immediately. Vocal fold sections were stained with antibodies against keratan sulfate, chondroitin sulfate, heparan sulfate proteoglycan (HSPG), decorin, and hyaluronate receptor. We found that the lamina propria has diffuse staining of fibrillar components with keratan sulfate and decorin. Intense staining was observed in the vocal ligament area with keratan sulfate. The HSPG was localized to the basement membrane zone. Chondroitin sulfate, HSPG, and hyaluronate receptor were detected in the cytoplasm of interstitial cells with immunocytochemical characteristics of macrophages. The keratan sulfate distribution suggests that fibromodulin may be significant in normal vocal folds. Production of HSPG and probably versican occurs in macrophages and fibroblasts in the lamina propria.

Reinke's Edema: Phonatory Mechanisms and Management Strategies

1997 ◽  
Vol 106 (7) ◽  
pp. 533-543 ◽  
Author(s):  
Steven M. Zeitels ◽  
Glenn W. Bunting ◽  
Robert E. Hillman ◽  
Traci Vaughn
Keyword(s):  
Lamina Propria ◽  
Fundamental Frequency ◽  
Vocal Fold ◽  
Management Strategies ◽  
Vocal Folds ◽  
Vocal Fold Vibration ◽  
Reinke’S Edema ◽  
Subglottal Pressure ◽  
Almost All ◽  
Superficial Lamina

Reinke's edema (RE) has been associated typically with smoking and sometimes with vocal abuse, but aspects of the pathophysiology of RE remain unclear. To gain new insights into phonatory mechanisms associated with RE pathophysiology, weused an integrated battery of objective vocal function tests to analyze 20 patients (19 women) who underwent phonomicrosurgical resection. Preoperative stroboscopic examinations demonstrated that the superficial lamina propria is distended primarily on the superior vocal fold surface. Acoustically, these individuals have an abnormally low average speaking fundamental frequency (123 Hz), and they generate abnormally high average subglottal pressures (9.7 cm H20). The presence of elevated aerodynamic driving pressures reflects difficulties in producing vocal fold vibration that are most likely the result of mass loading associated with RE, and possibly vocal hyperfunction. Furthermore, it is hypothesized that in the environment of chronic glottal mucositis secondary to smoking and reflux, the cephalad force on the vocal folds by the subglottal driving pressure contributes to the superior distention of the superficial lamina propria. Surgical reduction of the volume of the superficial lamina propria resulted in a significant elevation in fundamental frequency (154 Hz) and improvement in perturbation measures. In almost all instances, both the clinician and the patient perceived the voice as improved. However, these patients continued to generate elevated subglottal pressure (probably a sign of persistent hyperfunction) that was accompanied by visually observed supraglottal strain despite the normalsized vocal folds. This finding suggests that persistent hyperfunctional vocal behaviors may contribute to postsurgical RE recurrence if therapeutic strategies are not instituted to modify such behavior.

Hepatocyte Growth Factor and its Receptor C-Met in Rat and Rabbit Vocal Folds

2002 ◽  
Vol 111 (8) ◽  
pp. 661-666 ◽  
Author(s):  
Shigeru Hirano ◽  
Susan Thibeault ◽  
Charles N. Ford ◽  
Diane M. Bless ◽  
Shin-Ichi Kanemaru
Keyword(s):  
Wound Healing ◽  
Growth Factor ◽  
Hepatocyte Growth Factor ◽  
Lamina Propria ◽  
Vocal Fold ◽  
Vocal Folds ◽  
Enzyme Linked Immunosorbent Assay ◽  
Alternative Approach ◽  
Fibrotic Scar ◽  
Hepatocyte Growth

Vocal fold fibrotic scar is characterized by fibrosis of the lamina propria and epithelium, and is difficult to treat. Hepatocyte growth factor (HGF) has antifibrotic activity and has received attention as a possible therapeutic alternative to treat fibrosis. In this study, in order to clarify whether HGF can be involved in vocal fold scarring, we examined the existence of HGF and its receptor, c-Met, in rat vocal folds, and then the activity of HGF in rabbit injured vocal folds, using immunohistochemistry and enzyme-linked immunosorbent assay. We found HGF and c-Met on epithelial cells and gland cells of the rat vocal folds. On the injured vocal folds of rabbits, little HGF was observed immediately after injury, but prominent activity occurred simultaneously with reepithelialization of the vocal fold mucosa on days 10 to 15. The activity of HGF was observed on fibroblasts in the lamina propria, as well as the epithelium. It is suggested that HGF in the vocal folds is produced by the fibroblasts and delivered to the epithelium. The implication of these findings is that HGF is involved in wound healing of the vocal fold, and may provide an alternative approach in preventing and treating vocal fold scarring.

scholarly journals Adipose-Derived Mesenchymal Stem Cells in the Regeneration of Vocal Folds: A Study on a Chronic Vocal Fold Scar

2016 ◽  
Vol 2016 ◽  
pp. 1-12 ◽  
Author(s):  
Angelou Valerie ◽  
Kalodimou Vassiliki ◽  
Messini Irini ◽  
Psychalakis Nikolaos ◽  
Eleftheria Karampela ◽  
...  
Keyword(s):  
Stem Cells ◽  
Hyaluronic Acid ◽  
Lamina Propria ◽  
Vocal Fold ◽  
Rabbit Model ◽  
Vocal Folds ◽  
Scar Tissue ◽  
Elastic Fibers ◽  
Adipose Derived Stem Cells ◽  
Vocal Fold Scar

Background. The aim of the study was to assess the histological effects of autologous infusion of adipose-derived stem cells (ADSC) on a chronic vocal fold scar in a rabbit model as compared to an untreated scar as well as in injection of hyaluronic acid.Study Design. Animal experiment.Method. We used 74 New Zealand rabbits. Sixteen of them were used as control/normal group. We created a bilateral vocal fold wound in the remaining 58 rabbits. After 18 months we separated our population into three groups. The first group served as control/scarred group. The second one was injected with hyaluronic acid in the vocal folds, and the third received an autologous adipose-derived stem cell infusion in the scarred vocal folds (ADSC group). We measured the variation of thickness of the lamina propria of the vocal folds and analyzed histopathologic changes in each group after three months.Results. The thickness of the lamina propria was significantly reduced in the group that received the ADSC injection, as compared to the normal/scarred group. The collagen deposition, the hyaluronic acid, the elastin levels, and the organization of elastic fibers tend to return to normal after the injection of ADSC.Conclusions. Autologous injection of adipose-derived stem cells on a vocal fold chronic scar enhanced the healing of the vocal folds and the reduction of the scar tissue, even when compared to other treatments.

scholarly journals The Effect of Fibroblast Growth Factors in Grafted Fascia into the Vocal Fold of Rabbits

2018 ◽  
Vol 23 (01) ◽  
pp. 060-064
Author(s):  
Eduardo Carvalho ◽  
Almiro Machado-Júnior ◽  
Henrique Pauna ◽  
Ester Nicola ◽  
Albina Altemani ◽  
...  
Keyword(s):  
Growth Factors ◽  
Lamina Propria ◽  
Vocal Fold ◽  
Therapeutic Option ◽  
Fibroblast Growth Factors ◽  
Vocal Folds ◽  
Fibroblast Growth ◽  
Initial Experiment ◽  
Inflammatory Reactions ◽  
Tissue Integration

Introduction The human larynx is a very important organ for communication. Many conditions lead to scarring of the vocal folds, decreasing voice quality. Objective We aimed to determine whether fibroblast growth factors (FGFs) may influence tissue integration of grafted fascia into the vocal folds of an animal model. Methods This is an experimental animal study with 12 adult rabbits that were submitted to a grafting fragment obtained from superficial cervical fascia into the vocal fold lamina propria, bilaterally. The right vocal fold was injected with FGFs. The animals were sacrificed after 1 month or 12 months, depending on the group they were assigned to, and a histological analysis of their vocal folds was performed. We analyzed the histological changes (such as the presence of fibrosis and neovascularization) induced by the acute or chronic inflammatory reactions. Results The FGFs induced acute inflammatory changes in all animals after 1 month of the initial experiment. The presence of FGFs triggered more fibrosis than the expected due to the surgical procedure itself when compared with the control side of all animals after 12 months of the initial experiment. Conclusions Fibroblast growth factors alone do not represent a good therapeutic option in phonosurgery, since we observed higher levels of fibrosis in the vocal fold lamina propria. Further studies combining more substances may be necessary to elucidate the best option to be used in this kind of surgery.

Regeneration of Aged Vocal Folds with Basic Fibroblast Growth Factor in a Rat Model: A Preliminary Report

2005 ◽  
Vol 114 (4) ◽  
pp. 304-308 ◽  
Author(s):  
Shigeru Hirano ◽  
Tomoko Tateya ◽  
Hiromi Nagai ◽  
Charles N. Ford ◽  
Ichiro Tateya ◽  
...  
Keyword(s):  
Growth Factor ◽  
Fibroblast Growth Factor ◽  
Lamina Propria ◽  
Basic Fibroblast Growth Factor ◽  
Vocal Fold ◽  
Vocal Folds ◽  
Fibroblast Growth ◽  
Collagen Production

Aged vocal folds have been reported to have dense collagen deposition and decreased hyaluronic acid (HA) in the lamina propria. These characteristics are thought to contribute to vocal problems that occur with age (presbyphonia). To restore better viscoelasticity to aged vocal folds, an intervention that might increase HA and decrease collagen production from aged vocal fold fibroblasts would appear to be a potentially useful approach. Our previous in vitro study has revealed that basic fibroblast growth factor (bFGF) consistently stimulates HA production and decreases collagen production from aged rat vocal fold fibroblasts. The present in vivo study examined the effects of intracordal injection of bFGF into aged rats' vocal folds in terms of restoration of HA and collagen distribution in the lamina propria. We injected bFGF transorally into the lamina propria of (unilateral) vocal folds. The injection was repeated 4 times weekly, and rats were painlessly sacrificed 1 week, 1 month, and 2 months after the final injection. Histologic examination revealed that bFGF significantly increased the HA content of the lamina propria up to 2 months, but showed no effect on collagen, even after 2 months. Because it might take longer for excessive collagen to be degraded, further studies are necessary to clarify the long-term effect on collagen. A drug delivery system for bFGF also needs to be developed to maximize its effect in the future. The present study suggested at least a positive effect of bFGF in restoring the HA content in the aged vocal fold lamina propria.

Intra-Operative Laryngoscopic Instrument for Characterizing Vocal Fold Viscoelasticity

2007 ◽  
Author(s):  
Mark P. Ottensmeyer ◽  
Michael Yip ◽  
Conor J. Walsh ◽  
James B. Kobler ◽  
James T. Heaton ◽  
...  
Keyword(s):  
Epithelial Cells ◽  
Lamina Propria ◽  
Fundamental Frequency ◽  
Vocal Fold ◽  
Aging Process ◽  
Thick Layer ◽  
Vocal Folds ◽  
Natural Form ◽  
Vibrating Structures ◽  
Thyroarytenoid Muscle

Our society depends on communication, the most natural form of which is speech. Trauma, disease and the normal aging process will cause many to suffer degraded or lost vocal fold function, and it has been observed that this number is growing [1]. The vocal folds are the vibrating structures in the larynx that enable us to generate voice, from speech to opera singing. The vibrating portions of the folds consist of an external 0.1mm thick layer of epithelial cells, a soft, gel-like 0.5mm thick layer called the lamina propria (LP), a 0.3mm thick vocal ligament and an underlying thyroarytenoid muscle [2]. The fundamental frequency of speech in men is in the 100–150Hz range, and between 200 and 300Hz in women [3].

Use of Co2 Laser versus conventional microlaryngeal surgery in treatment of vocal fold benign lesions

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Hesham El-Halaby ◽  
Marwa M El-Begermy ◽  
Mina Zakaria Hakim
Keyword(s):  
Lamina Propria ◽  
Co2 Laser ◽  
Vocal Fold ◽  
Meta Analysis ◽  
Vocal Folds ◽  
Superficial Layer ◽  
Sufficient Evidence ◽  
Benign Lesions ◽  
Benign Vocal Fold Lesions ◽  
Microlaryngeal Surgery

Abstract Background Benign superficial lesions of vocal fold (nodule, polyp, cyst and Reinke's edema) arise from the epithelium and the lamina propria. Vocal abuse and misuse presumably lead to excessive mechanical stress and trauma in the membranous portion of vocal fold, resulting in wound formation. Wound healing leads to remodeling of the superficial layer of the lamina propria. This tissue remodeling leads to formation of benign vocal fold lesions. These lesions are classically treated by conventional microsurgery and recently by CO2 laser. The use of the CO2 laser for the surgical treatment of Minor Associated Pathological Lesions (MAPL's) is still controversial. Some preferred cold instruments, whereas others appreciate CO2 laser as a novel alternative to conventional microsurgery for benign vocal fold lesions. To summarize the reviewed literature the issue of CO2 laser versus cold instruments is still controversial and the stage is open for more studies. Aim The aim of this study is to investigate the effect of Co2 Laser versus cold instruments in the treatment of benign lesions of the vocal folds regarding voice outcome & vocal fold function. Methodology A meta-analysis study is done to assess the use of Co2 Laser versus conventional microlaryngeal surgery in treatment of vocal fold benign lesions. Results This study does not reveal any detectable differences in clinical outcomes in patients with nodules, polyps and cysts who underwent excision via CO2 laser or cold instruments. Conclusion There is no sufficient evidence to determine if conventional surgery or CO2 assisted surgery is better.

A Synopsis of the Management of Vocal Fold Scar

2009 ◽  
Vol 19 (1) ◽  
pp. 15-23
Author(s):  
Edie R. Hapner ◽  
Adam Klein
Keyword(s):  
Lamina Propria ◽  
Vocal Fold ◽  
Wave Motion ◽  
Behavioral Treatment ◽  
Vocal Folds ◽  
Voice Therapy ◽  
Pitch Range ◽  
Glottal Closure ◽  
Vocal Fold Scar

Abstract Vocal fold scarring remains one of the greatest therapeutic challenges in laryngology and voice therapy. The loss of superior lamina propria results in a change in the pliability of the vocal folds with changes in glottal configuration, glottal closure, and reduced to absent mucosal wave motion. This results in dysphonia of varying severities including breathiness, roughness, loss of pitch range, and flexibility. The aim of this article is to present a brief review of vocal fold architecture and a discussion of the etiologies of vocal fold scarring. Methods to evaluate vocal fold scarring are presented with examples of findings in laryngoscopic, acoustic, aerodynamic, and perceptual assessments. Medical, surgical, and behavioral treatment for vocal folds scaring including sample therapy tasks are included.

Imaging the Mucosa of the Human Vocal Fold with Optical Coherence Tomography

2005 ◽  
Vol 114 (9) ◽  
pp. 671-676 ◽  
Author(s):  
James A. Burns ◽  
Steven M. Zeitels ◽  
R. Rox Anderson ◽  
James B. Kobler ◽  
Mark C. Pierce ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Lamina Propria ◽  
Vocal Fold ◽  
Imaging Techniques ◽  
Vocal Folds ◽  
Superficial Layer ◽  
Optical Coherence ◽  
Cross Sectional ◽  
Superficial Lamina

Objectives: Discerning the layered microstructure of the vocal folds is critical for effective phonomicrosurgery. Optical coherence tomography (OCT), a noncontact, noninvasive technology that provides cross-sectional images by means of backscattered light, offers the potential for delineating these layers in vivo. Methods: The glottal mucosa of 3 human cadaver larynges was imaged with conventional OCT and polarization-sensitive OCT (PS-OCT). Images were obtained through the epithelium and lamina propria. Results: Although the superficial layer of the lamina propria appeared quite homogeneous, the outer surface of the superficial lamina propria was correlated with an increase in backscatter with OCT. The superficial lamina propria and vocal ligament were correlated with a marked increase in tissue birefringence with PS-OCT. Conclusions: This preliminary study demonstrates the capacity of OCT and PS-OCT for visualizing the layered microstructure of the vocal fold mucosa. We believe that these imaging techniques will have applications in the exploration of solutions to vocal fold scarring and in imaging vocal fold disorders in the clinic and operating room.

Effect of Growth Factors on Hyaluronan Production by Canine Vocal Fold Fibroblasts

2003 ◽  
Vol 112 (7) ◽  
pp. 617-624 ◽  
Author(s):  
Shigeru Hirano ◽  
Dennis Heisey ◽  
Diane M. Bless ◽  
Charles N. Ford
Keyword(s):  
Growth Factors ◽  
Growth Factor ◽  
Lamina Propria ◽  
Vocal Fold ◽  
Transforming Growth Factor ◽  
Vocal Folds ◽  
Transforming Growth Factor Β1 ◽  
Enzyme Linked Immunosorbent Assay ◽  
Positive Effects

Hyaluronan (HYA) is considered to be a crucial factor in scarless wound healing and in maintaining tissue viscosity of the vocal fold lamina propria. In this study focusing on the effects of growth factors, we examined how HYA is produced and controlled in canine cultured vocal fold fibroblasts. Fibroblasts were taken from the lamina propria of the vocal folds of 8 dogs and cultured with and without growth factors. The production of HYA in the supernatant culture was quantitatively examined by enzyme-linked immunosorbent assay. Hepatocyte growth factor, epidermal growth factor, basic fibroblast growth factor, and transforming growth factor β1 all stimulated HYA synthesis from vocal fold fibroblasts. These effects differed with the concentration of growth factors and the incubation period. We also examined how frequently the growth factors had to be administered in order to maintain appropriate levels of HYA. A single administration was sufficient to maintain appropriate HYA levels for at least 7 days. The present studies have demonstrated positive effects of growth factors in stimulating HYA production. Further in vivo study is needed to clarify the usefulness of these growth factors in the management of vocal fold scarring.

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