Cell therapy and vocal fold scarring

Abstract

Vocal fold microstructure is complex and can be affected by laryngeal microsurgery, inducing scarring that prevents mechanical uncoupling of epithelium and muscle, leading to vibration disorder and disabling dysphonia. Treatment options presently are few, and often without efficacy for vibration, having only an impact on volume to reduce glottal closure defect. The present review of the literature had two aims: (i) to report the current state of the literature on cell therapy in vocal fold scarring; and (ii) to analyze the therapeutic interest of the adipose-derived stromal vascular fraction in the existing therapeutic armamentarium. A PubMed search conducted in September 2016 retrieved English or French-language original articles on the use of stem cells to treat vocal fold scarring. Twenty-seven articles published between 2003 and 2016 met the study selection criteria. Mesenchymal stem cells were most widely used, mainly derived from bone marrow or adipose tissue. Four studies were performed in vitro on fibroblasts, and 18 in vivo on animals. End-points comprised: (i) scar analysis (macro- and micro-scopic morphology, viscoelastic properties, extracellular matrix, fibroblasts); and (ii) assessment of stem cell survival and differentiation. The studies testified to the benefit of mesenchymal stem cells, and especially those of adipose derivation. The stromal vascular fraction exhibits properties that might improve results by facilitating production logistics.

Autologous fibroblasts for vocal scars and age‐related atrophy: A randomized clinical trial

“…1,28,29 Cell-based therapy includes transplantation of pluripotent stem cells, mesenchymal stromal cells, or mature fibroblasts. Recent literature reviews [30][31][32] identified more than 30 in vitro and in vivo studies on cell therapy for vocal fold scarring alone. Translating these promising concepts to human trials has been much slower, as significant assurances of feasibility and safety are prerequisites before human administration.…”

Functional Outcome of Human Adipose Stem Cell Injections in Rat Anal Sphincter Acute Injury Model

“…Fibrosis is a histological finding often seen in scar tissue and in our model the follow up time was too short to analyze the possible impact on scar tissue formation. There is evidence that cell therapy might be able to prevent vocal fold scaring in laryngeal microsurgery and fibrous keloid formation after skin incision in acute trauma model [55,56].…”

Advances in regenerative medicine for otolaryngology/head and neck surgery

“…The other uses cells to directly restore normal anatomy. Many cell types have been studied for vocal fold regeneration,46 but fibroblasts and stem cells seem to be the most promising to date.…”