Relationship between the morphologic alterations of vocal cords from adult autopsies and the cause of death

Abstract

PURPOSE:The purpose of this study was to identify the possible alteration in the thickness of the epithelium basal membrane of the vocal cords and correlate it with the cause of death.METHOD: Larynxes collected from adult autopsies during the period of 1993 to 2001 were utilized. We used the hematoxylin-eosin and periodic acid-Schiff staining methods for the morphological and morphometric analysis.RESULTS: Sixty-six vocal cords were analysed; increased thickness was identified in 14 cases (21.2%), with equal proportions between the genders. Increased vocal-cord thickness was more frequent in patients of the white ethnicity (12 cases, 85.7%). Respiratory alterations were found in 10 (71.4%) of the cases with increased vocal-cord thickness. Of the patients that were maintained with mechanical ventilation before death, 7 (18.4%) had thickening of the basal membrane. Among the smokers, 9 (19.63%) had basal membrane thickening.CONCLUSION: No statistically significant differences were found between the cases in which the cause of death was related to respiratory diseases as compared to non-respiratory diseases and the thickening of the basal membrane of the vocal cords. However, new studies are needed in order to verify the etiopathogenesis of this thickening.

Descrição das lesões microscópicas das pregas vestibulares de adultos autopsiados e sua relação com as causas de óbito e doença de base

“…Later, the larynx was sectioned transversally at points above and below the glottic cavity and within 3cm one from the other. Parallel sections to the extremity of the vocal folds were made, transversally, and the fragment was processed for paraffin preparation 4 . We performed hematoxylineosin staining (HE) for morphological analysis.…”

“…Moreover, the importance of VF in protecting the body against infectious agents has been recently discussed 1,2 . In studies conducted with true vocal folds we can find the description of lesions such as thickness of basal membrane of true vocal folds epithelium and their relation with infectious diseases 4 , but there is no report on vestibular folds. As to microscopic lesions of VF, there are reports of lymphoid follicle hyperplasia of VF and the suggestion of the term laryngeal tonsil 5 to name the structure, since it has been observed that this tissue presents an organization and that it could be replaced by larynx associated lymphoid tissue 2 .…”

Description of microscopic lesions of vestibular folds of autopsied adults and their relationship with cause of death and underlying disease

“…Later, the larynx was sectioned transversally at points above and below the glottic cavity and within 3cm one from the other. Parallel sections to the extremity of the vocal folds were made, transversally, and the fragment was processed for paraffin preparation 4 . We performed hematoxylin-eosin staining (HE) for morphological analysis.…”

“…Moreover, the importance of VF in protecting the body against infectious agents has been recently discussed 1 , 2 . In studies conducted with true vocal folds we can find the description of lesions such as thickness of basal membrane of true vocal folds epithelium and their relation with infectious diseases 4 , but there is no report on vestibular folds. As to microscopic lesions of VF, there are reports of lymphoid follicle hyperplasia of VF and the suggestion of the term laryngeal tonsil 5 to name the structure, since it has been observed that this tissue presents an organization and that it could be replaced by larynx associated lymphoid tissue 2 .…”