Morphology of Fetal Vocal Fold and Associated Structures

Campos, Deivis de; Ellwanger, Joel Henrique; Rosa, João Paulo da Costa; Santos, Iuri Pereira dos; Corbellini, Raquel Oliveira; Hoelscher, Rafael Henrique; Bagatini, Pamela Brambilla; Jotz, Geraldo Pereira; Xavier, Léder Leal

doi:10.1016/j.jvoice.2012.09.002

Cited by 7 publications

(2 citation statements)

References 21 publications

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“…Even the youngest newborn in the study (6‐weeks‐old) depicts a three‐layered stratification based on image intensity. Although this outcome is more aligned with Nita et al 26 and De Campos et al 27 findings, the interpretability in terms of collagen and elastic fiber densities may need further investigations as scattering‐based OCT systems are not molecular sensitive. Nonetheless, there is evidence of a stratified extracellular matrix in newborns likely tied to the LP composition and the cellular density 24 .…”

Section: Discussionsupporting

confidence: 82%

“…4,8,12,22 The first appearance of a bilaminar structure was observed between 7 and 12 years of age 23,24 and a fully differentiated LP with a fibrous composition around age 13. 25 However, recently, using Picrosirius red and electron microscopy, a distribution of collagen and elastin was found in human fetuses, similar to the vocal ligament in adults, 26,27 challenging the previously accepted VF developmental paradigm. Although there are discrepancies regarding the presence or absence of a vocal ligament in a pediatric population, it is a common understanding that voice maturation is gradual through childhood and puberty and the timeline of critical developmental periods remains to be established.…”

Section: Introductionmentioning

confidence: 98%

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Evaluation of the Human Vocal Fold Lamina Propria Development Using Optical Coherence Tomography

et al. 2021

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Objectives/Hypothesis Identifying distinctive features of the vocal fold (VF) during development could have significant clinical implications for treating voice disorders. This study investigates the structural organization of the VF microanatomy across gender and age groups using optical coherence tomography (OCT). Study Design Prospective clinical trial. Materials and Methods In vivo OCT images were acquired from 97 patients (58 males and 39 females) aged between 6 weeks and 27 years. All patients showed no signs of vocal fold pathology on endoscopy. Morphological features were extracted from OCT images and statistically compared between age groups. This study was performed at Massachusetts Eye and Ear between 2017 and 2019. Results All OCT acquisitions show a stratified microanatomy across age groups, even in newborns suggesting the presence of a superficial lamina propria (SLP) at birth. Furthermore, the optical scattering in the VF lamina propria changes according to age, suggesting subepithelial maturation. Although the epithelium thickness was relatively constant across age groups, the SLP showed a significant linear relationship between age and thickness (P = .016). Furthermore, a significant difference (P = .002) in SLP thickness was found between young adult males and females. The overall thickness of the entire mucosa did not change significantly with age. Conclusion OCT is a noninvasive imaging modality capable of providing quantitative morphological features to describe the VF development. A stratified structure can be observed in OCT from newborns to young adults. Further investigations could combine OCT, acoustic measurements, and molecular sensitive techniques to provide a complete interpretation of the VF development. Level of Evidence NA Laryngoscope, 131:E2558–E2565, 2021

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Section: Discussionsupporting

confidence: 82%