Summary
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.
Key Words
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Article info
Publication history
Published online: February 01, 2021
Accepted:
January 7,
2021
Footnotes
Funding: Funding was provided from R01DC0115545 (National Institutes of Health/National Institute on Deafness and other Communication Disorders) and NSF CMMI 1911346 (National Science Foundation/Division of Civil, Mechanical & Manufacturing Innovation).
Conflict of Interest: None to report.
Identification
Copyright
© 2021 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
