In this population of 2019 patients with dysphonia, adults and women were predominant. Dysphonia had different etiologies in the age groups studied. Nodules and cysts were predominant in children, functional dysphonia and reflux in adults, and presbyphonia and Reinke's edema in the elderly.

A clear increase of collagens I and III and a decrease of elastic fibers were observed in the lamina propria of vocal folds. The concentration of collagens IV and V was the same across age groups. These findings suggest that as men age, the density of the extracellular matrix increases, brought about by an increase in collagen, while the loss of elastin results in decreased viscoelasticity.

Resumo: FUNDAMENTOS -Drogas podem desencadear reações adversas. As manifestações cutâneas são as mais comuns. OBJETIVO -Analisar as farmacodermias e relacionar as drogas envolvidas e os tipos de reações cutâneas mais freqüentes.

Introduction. Microscopy studies of presbylarynx have identified epithelial atrophy, as well as vocal muscle atrophy, increased collagen, and decreased nonfibrous proteins of the extracellular matrix. Studies on the ultrastructure of presbylarynx are rare and can help us understand the pathophysiology of presbyphonia. Objective. To describe details on the ultrastructure of presbylarynx by transmission electron microscopy (TEM). Subjects and Methods. Sixteen human larynges were removed and distributed in two groups: control (n = 8; 30-50 years; six females, two males) and seniors (n = 8; 75-92 years; six females, two males). After preparation for TEM, the specimens, including epithelium and lamina propria, were examined and photographed at increasing magnification. Results. Control: the epithelium was intact, with overlapped cells, and with desmosomes between the intercellular junctions. The basement membrane was continuous and uniform, and the lamina propria contained collagen and elastic fibers in a regularly distributed loose arrangement, as well as some fibroblasts of different shapes. Senior: the epithelial cells were separated by enlarged intercellular junctions. The basement membrane was delicate and continuous. In the lamina propria there was predominance of elongated fibroblasts. Under the basement membrane a dense network of collagen fibers could be identified. Conclusions. In this study with TEM some structural changes were identified, particularly in the larynx of the elderly, both in the epithelium and lamina propria, some of them with likely participation of fibroblasts, which reinforces the importance of additional ultrastructure as well as molecular studies targeting those cells, as they are the main precursors of the components of the extracellular matrix.

ABSTRACT. We found evidence of autosomal dominant hereditary transmission of sulcus vocalis. Four dysphonic patients from three generations of the same family were submitted to videolaryngoscopic examination (three patients) and to direct laryngoscopy (one patient) to diagnose the hoarseness. Sulcus vocalis was diagnosed in all four patients. The finding of four affected individuals in three generations, with vertical transmission affecting man and women, is more consistent with autosomal dominant inheritance pattern; it is an etiological model that we propose for the sulcus vocalis in this pedigree.