Our analysis of the published CI5 data illustrates that the incidence of thyroid cancer increased between 1998-2002 and 2003-2007 in most populations worldwide, and rising rates continue in all regions of the world.

Objective To investigate the effects of increasing time and magnitude doses of vibration exposure on transcription of the vocal fold's junctional proteins, structural alterations, and functional tissue outcomes. Study Design Animal study. Methods 100 New Zealand White breeder rabbits were studied. Dependent variables were measured in response to increasing time doses (30, 60, or 120 minutes) and magnitude doses (control, modal intensity, and raised intensity) of vibration exposure. Messenger RNA expression of occludin, zonula occluden-1 (ZO-1), E-cadherin, β-catenin, interleukin 1β (IL-1β), cyclooxygenase-2 (COX-2), transforming growth factor β-1 (TGFβ1), and fibronectin were measured. Tissue structural alterations were assessed using transmission electron microscopy (TEM). Transepithelial resistance was used to measure functional tissue outcomes. Results Occludin gene expression was downregulated in vocal folds exposed to 120 minute time doses of raised intensity phonation, relative to control, and modal intensity phonation. ZO-1 gene expression was upregulated following a 120 minute time dose of modal intensity phonation, compared to control, and downregulated after a 120 minute time dose of raised intensity phonation, compared to modal intensity phonation. E-cadherin gene expression was downregulated after a120 minute time dose of raised intensity phonation, compared to control and modal intensity phonation. TEM revealed extensive desquamation of the stratified squamous epithelial cells with increasing time and magnitude doses of vibration exposure. A general observation of lower transepithelial resistance measures was made in tissues exposed to raised intensity phonation, compared to all other groups. Conclusions This study provides evidence of vocal fold tissue responses to varying time and magnitude doses of vibration exposure. Level of Evidence N/A

Objectives/Hypothesis To investigate phonation-related extracellular matrix (ECM) changes in the vocal fold lamina propria after microflap surgery using an in vivo rabbit phonation model. Study Design Prospective animal study. Methods Twenty-four New Zealand White rabbits were used in this study. Quantitative polymerase chain reaction and immunohistochemistry were used to investigate alterations in vocal fold ECM proinflammatory and profibrotic gene, and protein expression from a control group of animals receiving a microflap without phonation and a separate group of animals receiving experimentally induced phonation on postmicroflap days 0, 3, and 7. Results IHC demonstrated the highest concentration of CD45 in vocal folds on postoperative day 0. Staining for CD45 was absent by postoperative day 7, with no differences in CD45 staining between groups. Fibronectin gene expression increased significantly on postoperative day 3 in the control and experimentally induced phonation groups, with maximal staining of fibronectin around the microflap incision on postoperative day 7. No alterations in cyclooxygenase-2, interleukin-1β, and transforming growth factor-β1 gene expression were observed between groups. Conclusions Results of the present study revealed an acute inflammatory response in the vocal fold at the time of microflap (day 0) and up to 3 days post-microflap. By post-operative day 3, staining of CD45 positive cells decreased, with essentially no evidence of inflammation by post-operative day 7. With the end of the acute inflammatory response occurring around day 3, these data may provide support for mobilizing tissue after inflammation has subsided and the process of active tissue remodeling has ensued (days 3–7).

Objectives/Hypothesis The purpose of this study was to evaluate the return of vibratory function and restoration of vibration amplitude and symmetry after vocal fold microflap surgery. Study Design Prospective in vivo animal model. Methods Microflap surgery was performed on 30 New Zealand white breeder rabbits. The left vocal fold received a 3-mm epithelial incision and mucosal elevation, while the contralateral vocal fold was left intact to serve as an internal control. Quantitative analysis of amplitude ratio and lateral phase difference were measured using high-speed laryngeal imaging at a frame rate of 10,000 frames per second from animals undergoing evoked phonation on postoperative days 0, 1, 3, 5, and 7. Results Quantitative measures revealed a significantly reduced amplitude ratio and lateral phase difference on day 0 after microflap. These impairments of vibratory function on day 0 were associated with separation of the vocal fold’s bodycover layer. Amplitude ratio increased significantly by day 3 after microflap, with further increases in vibration amplitude on days 5 and 7. While the amplitude ratio improved significantly on day 3, lateral phase difference decreased significantly on day 3, and returned to normal on days 5 and 7. Conclusions High-speed laryngeal imaging was used to investigate the natural time course of postmicroflap recovery of vibratory function. Results revealed the restoration of vibration amplitude and lateral phase difference by days 3 to 7 after microflap. The time period of improved vibratory function observed in this study coincides with the end of the well-documented inflammatory phase of vocal fold wound repair.

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