Hydration State and Hyaluronidase Treatment Significantly Affect Porcine Vocal Fold Biomechanics.

OBJECTIVES: The understanding of vocal fold hydration state, including dehydrated, euhydrated, rehydrated tissue, and how hydration affects vocal fold biomechanical properties is still evolving. Although clinical observations support the benefits of increasing vocal fold hydration after dehydrating events, more mechanistic information on the effects of vocal fold dehydration and the beneficial effects of rehydration are needed. Alterations to hyaluronic acid (HA), an important component of the vocal fold extracellular matrix, are likely to influence the biomechanical properties of vocal folds. In this study, we investigated the influence of hydration state and HA on vocal fold tissue stiffness via biomechanical testing. STUDY DESIGN: Prospective, ex vivo study design. METHODS: Fresh porcine vocal folds (N = 18) were examined following sequential immersion in hypertonic (dehydration) and isotonic solutions (rehydration). In a separate experiment, vocal folds were incubated in hyaluronidase (Hyal) to remove HA. Control tissues were not exposed to any challenges. A custom micromechanical system with a microforce sensing probe was used to measure the force-displacement response. Optical strain was calculated, and ultrasound imaging was used to measure tissue cross-sectional area to obtain stress-strain curves. RESULTS: Significant increases (P ≤ 0.05) were found in tangent moduli between dehydrated and rehydrated vocal folds at strains of ε = 0.15. The tangent moduli of Hyal-digested tissues significantly increased at both ε = 0.15 and 0.3 (P ≤ 0.05). CONCLUSION: Vocal fold dehydration increased tissue stiffness and rehydration reduced the stiffness. Loss of HA increased vocal fold stiffness, suggesting a potential mechanical role for HA in euhydrated vocal folds.

A Review of Hyaluronic Acid and Hyaluronic Acid-based Hydrogels for Vocal Fold Tissue Engineering.

Vocal fold scarring is a common cause of dysphonia. Current treatments involving vocal fold augmentation do not yield satisfactory outcomes in the long term. Tissue engineering and regenerative medicine offer an attractive treatment option for vocal fold scarring, with the aim to restore the native extracellular matrix microenvironment and biomechanical properties of the vocal folds by inhibiting progression of scarring and thus leading to restoration of normal vocal function. Hyaluronic acid is a bioactive glycosaminoglycan responsible for maintaining optimum viscoelastic properties of the vocal folds and hence is widely targeted in tissue engineering applications. This review covers advances in hyaluronic acid-based vocal fold tissue engineering and regeneration strategies.

Spatiotemporal Quantification of Vocal Fold Vibration After Exposure to Superficial Laryngeal Dehydration: A Preliminary Study.

OBJECTIVES: The aim of the study was to evaluate the effects of a superficial laryngeal dehydration challenge on vocal fold vibration in young healthy adults using high-speed video imaging. SUBJECTS AND METHODS: In this prospective study, the effects of a 60-minute superficial laryngeal dehydration challenge on spatial (speed quotient, amplitude quotient) and temporal measures (jitter percentage, vibratory onset time) of vocal fold vibration and phonation threshold pressure (PTP) were evaluated in 10 (male = 4, female = 6) vocally normal adults (21-29 years). All measures except the vibratory onset time were measured at the 10 (low) and 80 (high) percent level of their pitch range. The vibratory onset time was obtained at habitual pitch and loudness level. Superficial laryngeal dehydration was induced by oral breathing in low ambient humidity. Prechallenge and postchallenge differences were statistically investigated using t tests with Bonferroni correction. RESULTS: The speed quotient at low-pitch phonation significantly decreased after oral breathing of low ambient humidity. Other spatiotemporal measures and PTP at low and high pitch were not significant after challenge. CONCLUSIONS: Results from this initial study have implications for the use of high-speed video imaging to detect and quantify the subtle changes in vocal fold vibrations after superficial dehydration in healthy individuals. Preliminary findings indicate that superficial dehydration in healthy individuals results in spatial deviations at low pitch. However, further studies are warranted to identify additional spatiotemporal changes in vocal fold vibration after superficial dehydration in normal and disordered populations.

Robust and semi-interpenetrating hydrogels from poly(ethylene glycol) and collagen for elastomeric tissue scaffolds.

Here we present an injectable PEG/collagen hydrogel system with robust networks for use as elastomeric tissue scaffolds. Covalently crosslinked PEG and physically crosslinked collagen form semi-interpenetrating networks. The mechanical strength of the hydrogels depends predominantely on the PEG concentration but the incorporation of collagen into the PEG network enhances hydrogel viscoelasticity, elongation, and also cell adhesion properties. Experimental data show that this hydrogel system exhibits tunable mechanical properties that can be further developed. The hydrogels allow cell adhesion and proliferation in vitro. The results support the prospect of a robust and semi-interpenetrating biomaterial for elastomeric tissue scaffolds applications.