Hyaluronic acid hydrogels for vocal fold wound healing

Abstract

The unique vibrational properties inherent to the human vocal fold have a significant detrimental impact on wound healing and scar formation. Hydrogels have taken prominence as a tissue engineered strategy to restore normal vocal structure and function as cellularity is low. The frequent vibrational and shear forces applied to, and present in this connective tissue make mechanical properties of such hydrogels a priority in this active area of research. Hyaluronic acid has been chemically modified in a variety of ways to address cell function while maintaining desirable tissue mechanical properties. These various modifications have had mixed results when injected in vivo typically resulting in better biomechanical function but not necessarily with a concomitant decrease in tissue fibrosis. Recent work has focused on seeding mesenchymal progenitor cells within 3D architecture of crosslinked hydrogels. The data from these studies demonstrate that this approach has a positive effect on cells in both early and late wound healing, but little work has been done regarding the biomechanical effects of these treatments. This paper provides an overview of the various hyaluronic acid derivatives, their crosslinking agents, and their effect when implanted into the vocal folds of various animal models.

Time for Complete Vocal Recovery in Voice Professionals Undergoing Polyp Surgery

“…There was a significant statistical difference only between the preoperative vs. 1 month moments and not significant between the 1 month vs. 2 months and 2 months vs. 3 months moments [22]. of nodules in females and polyps in males [16,17]. In accordance with the literature, this study has shown higher incidence of polyps in males, with 38 cases (55.8%) [18][19][20].…”

Tissue engineering-based therapeutic strategies for vocal fold repair and regeneration

“…This strategy also minimizes the invasiveness and potential trauma to patients, limits the risk of infection and secondary scar formation, and reduces treatment costs with easy practice and increased patient accessibility. [10,65] To date, injectable hydrogels investigated for vocal fold tissue regeneration have largely focused on hyaluraonic acid (HA) and its derivatives due to the significant relevance of HA’s biological and biomechanical functionalities in vivo . [65,66]…”

“…[10,65] To date, injectable hydrogels investigated for vocal fold tissue regeneration have largely focused on hyaluraonic acid (HA) and its derivatives due to the significant relevance of HA’s biological and biomechanical functionalities in vivo . [65,66]…”

“…Specifically, the largely extended, loosely coiled molecular structure of HA allows extensive hydrogen bonding with water to yield highly viscous solutions, and thus it functions as a shock absorber to resist tissue compression where it acts as a tissue damper to protect the edges of vocal folds from oscillatory trauma encountered during sound production. [65,68] Furthermore, the osmotic, viscoelastic and space-filling features of HA are critical in phonation as these properties influence the thickness, shape, and viscosity of the vocal fold. [68,69] HA also interacts with cells through multiple cell surface receptors (e.g.…”

“…No statistical difference between fibrosis levels observed in saline-treated controls (p=0.1645); (C) Saline treated controls showing moderate fibrosis. [65] Reprinted with permission from Gaston, J. and Thibeault, S. L. Biomatter ( 2013 ) 3 , e23799. Copyright (2013) Taylor & Francis Group.…”