Hydration State and Hyaluronidase Treatment Significantly Affect Porcine Vocal Fold Biomechanics

Duan, Chenwei; Jimenez, Julian M.; Goergen, Craig J.; Cox, Abigail; Sivasankar, Preeti M.; Calve, Sarah

doi:10.1016/j.jvoice.2021.01.014

Cited by 5 publications

(5 citation statements)

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“…Interestingly, restored blood flow after water intake does not necessarily represent a complete functional recovery of vocal fold tissue. Our previous work suggests biological changes of vocal fold following dehydration are not restored to pre‐dehydration states 20,29 . Therefore, future work is needed to include a longer recovery time period and compare water versus oral rehydration treatments in supporting rehydration.…”

Section: Discussionmentioning

confidence: 99%

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In Vivo Visualization and Quantification of Rat Laryngeal Blood Supply After Hydration Challenge

et al. 2023

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ObjectivesSystemic dehydration decreases total body blood volume; however, hemodynamic alterations at the level of local organs, such as the larynx, remain unclear. Here we sought to quantify superior thyroid artery (STA) blood flow after dehydration and rehydration using in vivo magnetic resonance angiography (MRA) and ultrasound imaging in a rat model.MethodsMale Sprague–Dawley rats (N = 17) were included in this prospective, repeated measures design. Rats first underwent MRA to determine baseline STA cross‐sectional area, followed by high‐frequency in vivo ultrasound imaging to measure STA blood velocity at baseline. Next, rats were systemically dehydrated (water withholding), followed by rehydration (water ad‐lib). Ultrasound imaging was repeated immediately after dehydration and following rehydration. The STA blood velocity and STA cross‐sectional area were used to compute STA blood flow. Three rats served as temporal controls for ultrasound imaging. To determine if the challenges to hydration status affected the STA cross‐sectional area, four rats underwent only MRA at baseline, dehydration, and rehydration.ResultsSystemic dehydration resulted in 10.5% average body weight loss. Rehydration resulted in average body weight gain of 10.9%. Statistically significant reductions were observed in STA mean blood flow rate after dehydration. Rehydration reversed these changes to pre‐dehydration levels. No significant differences were observed in STA cross‐sectional area with dehydration or rehydration.ConclusionSystemic dehydration decreased blood flow in the superior thyroid artery. Rehydration restored blood flow in the STA. Change in hydration status did not alter the STA cross‐sectional area. These preliminary findings demonstrate the feasibility of using ultrasound and MRA to quantify hemodynamic changes and visualize laryngeal blood vessels.Level of EvidenceN/A Laryngoscope, 2023

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Section: Discussionmentioning

confidence: 99%

“…Our previous work suggests biological changes of vocal fold following dehydration are not restored to predehydration states. 20,29 Therefore, future work is needed to include a longer recovery time period and compare water versus oral rehydration treatments in supporting rehydration.…”

Section: Discussionmentioning

confidence: 99%

In Vivo Visualization and Quantification of Rat Laryngeal Blood Supply After Hydration Challenge

et al. 2023

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“…In the second session, the researcher explained voice production physiology and the superficial and systemic hydration mechanisms [31][32][33][34][35] with suggestions on how to improve it; thus, the pedagogy tools employed were knowledge enhancement and vocal hygiene. In the third session, participants had their diagnoses described, were asked about how much water they have drunk, and if they have performed superficial hydration in the past week; therefore, the pedagogy tools knowledge enhancement and vocal hygiene were applied.…”

Section: Treatment Proceduresmentioning

confidence: 99%

Indirect Vocal Therapy as a Treatment Program for Behavioral Dysphonia: A Pilot Study

Antonetti-Carvalho

Victor

Brasolotto

et al. 2023

Folia Phoniatr Logop

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Introduction: Indirect Vocal Therapy (IVT) has tools that aim to modify an individual's behavior emotional factors, and physical environment for restoring vocal quality. Then, vocal health guidance may promote the desire for caring about the voice and prevent or treat behavioral dysphonia. However, studies that used parts of IVT have shown conflicting results. Hence, the main objective of this study was to introduce an IVT program based on the taxonomy of Van Stan et al. The second objective of this study was to analyze the preliminary effects of the IVT program on vocal comfort through the self-assessment of vocal fatigue, vocal symptoms, vocal handicap, and vocal quality in patients diagnosed with behavioral dysphonia. Method: This is an experimental, analytical, and prospective pilot study. Nine participants (five women; four men) aged between 18-50 years old with behavioral dysphonia participated in this study. They underwent the IVT program with guidance about vocal health, general health, emotional factors, and motivation. The therapy was implemented twice per week, totalizing eight sessions, each lasting 35 minutes. Participants were assessed before therapy started (M1), after it ended (M2), and one month after as a follow-up (M3). As assessment, participants filled in the Vocal Fatigue Index (VHI), Voice Symptoms Scale (VoiSS), and Vocal Handicap Index (VHI). Additionally, they had their voices recorded for acoustic measures (i.e., cepstral peak prominence-smoothed, alpha ratio, and L1-L0) and auditory-perceptual analysis using the GRBASI scale. Results: The acoustic measures and auditory-perceptual analysis showed no significant differences between the assessment moments. The auditory-perceptual analysis showed a mild deviation in participants' vocal quality. The participants’ scores of the VFI, VoiSS, and VHI were lower in M2 and remained lower in M3. Conclusion: The Indirect Vocal Therapy program had positive results in voice-related self-assessment and vocal comfort. However, further studies are necessary to elucidate its effects on the vocal quality of participants with behavioral dysphonia.

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“…[3][4][5] In vitro studies to explore the etiology of dehydration-induced changes suggest accompanying viscoelastic alterations of the vocal fold tissue as a potential contributing factor. 6,7 Unfortunately, tissues collected postmortem or surgically resected with underlying pathology are likely to contribute to bias in extrapolating to the healthy population, and in vitro models are limited in addressing the homeostatic compensation within the in situ environment. Thus, a holistic biological approach is required to fully describe this phenomenon.…”

Section: Introductionmentioning

confidence: 99%

“…There is a body of evidence demonstrating that both systemic and superficial dehydration of the airway lumen can contribute to voice change; however, considering obvious ethical concerns, studies in live humans are restricted to acoustic and aerodynamic impacts of voice and visual inspection of anatomy 3–5 . In vitro studies to explore the etiology of dehydration‐induced changes suggest accompanying viscoelastic alterations of the vocal fold tissue as a potential contributing factor 6,7 . Unfortunately, tissues collected postmortem or surgically resected with underlying pathology are likely to contribute to bias in extrapolating to the healthy population, and in vitro models are limited in addressing the homeostatic compensation within the in situ environment.…”

Section: Introductionmentioning

confidence: 99%

Impact of Rehydration Following Systemic Dehydration on Vocal Fold Gene Expression

et al. 2023

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ObjectiveBiological data on the beneficial effects of vocal fold rehydration are lacking. This study aimed to examine the effects of acute systemic dehydration on vocal fold gene expression and determine whether rehydration would reverse these changes.MethodsMale New Zealand White rabbits (N = 24, n = 8/group) provided the animal model. Systemic dehydration was induced by 5 days of water volume restriction. Rehydration was provided by ad‐lib water for 3 days following dehydration. Euhydrated rabbits were used as the control group. Vocal fold tissue was dissected. Seventeen genes were selected based on physiological function and role in supporting vocal fold structure, oxidative stress, hemodynamics, and extracellular matrix turnover. Relative gene expression was assessed by RT‐qPCR.ResultsRehydration following systemic dehydration can modulate gene expression, with expression patterns suggesting that rehydration reverses dehydration‐induced changes in over half of the tested genes. CLIC5 (chloride intracellular channel 5) and EFEMP1 (EGF containing fibulin extracellular matrix protein 1) genes were significantly upregulated in the dehydration group compared with the euhydrated control. A1BG (alpha‐1B‐glycoprotein) and IL1RAP (interleukin 1 receptor accessory protein) were downregulated by rehydration compared with the dehydration group.ConclusionThis study provides molecular evidence for a transcriptional response to rehydration following acute systemic dehydration in the vocal folds. These data are the first to study gene expression following realistic dehydration and rehydration paradigms and provide biological data to support clinical recommendations to increase water intake after acute dehydration.Level of EvidenceN/A Laryngoscope, 2023

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Hydration State and Hyaluronidase Treatment Significantly Affect Porcine Vocal Fold Biomechanics

Cited by 5 publications

References 42 publications

In Vivo Visualization and Quantification of Rat Laryngeal Blood Supply After Hydration Challenge

In Vivo Visualization and Quantification of Rat Laryngeal Blood Supply After Hydration Challenge

Indirect Vocal Therapy as a Treatment Program for Behavioral Dysphonia: A Pilot Study

Impact of Rehydration Following Systemic Dehydration on Vocal Fold Gene Expression

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