Evaluation of the Human Vocal Fold Lamina Propria Development Using Optical Coherence Tomography

Abstract

Objectives/Hypothesis Identifying distinctive features of the vocal fold (VF) during development could have significant clinical implications for treating voice disorders. This study investigates the structural organization of the VF microanatomy across gender and age groups using optical coherence tomography (OCT). Study Design Prospective clinical trial. Materials and Methods In vivo OCT images were acquired from 97 patients (58 males and 39 females) aged between 6 weeks and 27 years. All patients showed no signs of vocal fold pathology on endoscopy. Morphological features were extracted from OCT images and statistically compared between age groups. This study was performed at Massachusetts Eye and Ear between 2017 and 2019. Results All OCT acquisitions show a stratified microanatomy across age groups, even in newborns suggesting the presence of a superficial lamina propria (SLP) at birth. Furthermore, the optical scattering in the VF lamina propria changes according to age, suggesting subepithelial maturation. Although the epithelium thickness was relatively constant across age groups, the SLP showed a significant linear relationship between age and thickness (P = .016). Furthermore, a significant difference (P = .002) in SLP thickness was found between young adult males and females. The overall thickness of the entire mucosa did not change significantly with age. Conclusion OCT is a noninvasive imaging modality capable of providing quantitative morphological features to describe the VF development. A stratified structure can be observed in OCT from newborns to young adults. Further investigations could combine OCT, acoustic measurements, and molecular sensitive techniques to provide a complete interpretation of the VF development. Level of Evidence NA Laryngoscope, 131:E2558–E2565, 2021

The life‐cycle and restoration of the human vocal fold

“… 37 , 38 Optical coherence tomography also indicates the depth of the superficial layer expands during this time while the intermediate and deep layers remain static. 39 Whether hormones involved in puberty directly or indirectly stimulate protein synthesis and organization within the lamina propria is debatable. While sex hormone receptors have been identified in the lamina propria of adult vocal folds, 40 , 41 other studies have failed to replicate these findings and the arrangement of receptors on vocal fold cells in adolescence is poorly characterized.…”

“…Immunohistochemistry and electron microscopy shows a further maturation of the vocal ligament during puberty with a more clearly defined deep collagenous layer and elastin predominant intermediate layer 37,38 . Optical coherence tomography also indicates the depth of the superficial layer expands during this time while the intermediate and deep layers remain static 39 . Whether hormones involved in puberty directly or indirectly stimulate protein synthesis and organization within the lamina propria is debatable.…”

Internet of Things and Cloud Computing Integration of Opera Elements into Vocal Singing Teaching Practice Exploration

“…Modern IoT and cloud computing can be used to support traditional vocal programs. Based on theoretical knowledge and years of experience in vocal lessons, they are summarizing the experience as a practical supplement to this paper, reading a large number of domestic and international literature, analyzing the possibility of IoT technology and cloud computing applied to traditional vocal lessons (Benboujja et al, 2021). Finally, specific measures are proposed to support formal vocal music lessons through IoT technology and cloud computing.…”

Tissue Engineering as a Promising Treatment for Glottic Insufficiency: A Review on Biomolecules and Cell-Laden Hydrogel

“…Three layers—cover, transition, and body—are thought to make up a human vocal fold [ 15 ]. Collagen, elastin, hyaluronic acid (HA), decorin, and fibronectin make up the majority of the extracellular matrix (ECM) proteins found in the lamina propria [ 16 ].…”

“…Collagen provides mechanical support to the vocal fold while elastin maintains the elasticity of the vocal fold [ 18 , 19 ]. The vocalis muscle makes up the body layer, which forms the base of this intricate three-dimensional structure [ 15 ]. Interestingly, cell junctions hold stratified squamous epithelium, which serves as a protective layer around membranous vocal folds [ 20 ].…”