Immunohistochemical examinations of sex hormone receptors in benign vocal fold lesions.

BACKGROUND: Acquired benign vocal fold lesions are among the most common causes of voice problems. Since the local impact of estrogen and progesterone receptors in laryngeal tissue is discussed controversially, the presence of sex hormone receptors in benign vocal fold alterations needs to be clarified. GOAL OF THE STUDY: To investigate the expression of estrogen-alpha receptors (ER-alpha), estrogen-beta receptors (ER-beta), progesterone receptors (PR) and androgen receptors (AR) in acquired benign vocal fold alterations. METHODS: Laryngeal epithelial specimens of 14 patients (13 female, 1 male) taken intraoperatively were investigated using immunohistochemistry in order to objectify ER-alpha, ER-beta, PR and AR. Macroscopically and histopathologically diagnosed edemas of Reinke's space (n = 10), vocal fold polyps (n = 3) and vocal fold nodules (n = 1) were enrolled in this study. RESULTS: No specific nuclear immunohistochemical staining could be seen in the biopsies taken. Only unspecific staining patterns could be observed. CONCLUSION: Sex hormone receptors could not be detected in the specimens tested, thus, any direct influence of sex hormones on the development of benign vocal fold lesions is rather unlikely. The results of this study confirm the impact of vocal fold stress and biomechanical abnormalities on their development due to voice overstraining and abuse.

Towards the expression of sex hormone receptors in the human vocal fold.

BACKGROUND: The human larynx is assumed to be a steroid receptor target organ. There are only very limited data on the evidence of steroid receptors in the vocal folds, although voice alterations due to hormonal influence and treatment have been found. GOAL OF THE STUDY: To investigate the expression of estrogen alpha, progesterone, and androgen receptors in human vocal folds (vocalis muscle, glands, lamina propria, epithelium). METHODS: Immunohistochemically, vocal fold cadaver specimens of 15 autopsied patients (6 women, 9 men), which were taken approximately 4 to 8 hours postmortem were investigated. Furthermore, one (male) vocal fold biopsy obtained intraoperatively during a laryngectomy was tested. RESULTS: No specific immunohistochemical staining for the different types of steroid hormones investigated could be observed in either the postmortem taken biopsies nor the intraoperatively one. However, several unspecific staining patterns could be observed. CONCLUSION: The results of this study contradict recently published data and question the expression of sex hormone receptors in the vocal folds. Main causes of false interpretations of unspecific staining are discussed.