Summary
Vocal fold scarring remains a significant problem. Although several animal models
have been developed to improve our understanding of the histopathology, the histologic
features of scarred human vocal folds have rarely been reported. The present case
studies aimed to define the histologic changes of scarred human vocal folds caused
by cordectomy or cordotomy. Ten patients with the scarred vocal folds were involved
in this study. Nine patients with early glottic cancer underwent endoscopic cordectomy,
and one patient underwent superficial cordotomy for idiopathic scar. The postcordectomy
or cordotomy scar was biopsied or resected 3–13 months after the original procedure.
After confirming absence of any tumor in cancer patients, the remaining specimens
were used in the present study. Histologic examination investigated deposition of
extracellular matrix (ECM) including collagen, elastin, hyaluronic acid (HA), fibronectin,
and decorin in the lamina propria of the scarred vocal folds. There was a wide range
of variation in the deposition of ECM in scarred vocal folds. Excessive and disorganized
collagen deposition was observed in most cases that had undergone deep resection of
the lamina propria, whereas deposition of collagen was mild and well organized after
superficial resection. Decorin was retained in all cases after superficial cordectomy
or cordotomy, but varied after deep resection. Deposition of elastin, HA, and fibronectin
varied regardless of depth of injury. Histology of scarred vocal folds may vary with
degree of injury and individual healing mechanism.
Key Words
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Article info
Publication history
Published online: April 07, 2008
Accepted:
December 4,
2007
Footnotes
This paper was presented at Annual Symposium of The Voice Foundation in Philadelphia in 2007.
Identification
Copyright
© 2009 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
