Transmission Electron Microscopy of the Presbylarynx in the Process of Voice Aging

Abstract

Introduction. Microscopy studies of presbylarynx have identified epithelial atrophy, as well as vocal muscle atrophy, increased collagen, and decreased nonfibrous proteins of the extracellular matrix. Studies on the ultrastructure of presbylarynx are rare and can help us understand the pathophysiology of presbyphonia. Objective. To describe details on the ultrastructure of presbylarynx by transmission electron microscopy (TEM). Subjects and Methods. Sixteen human larynges were removed and distributed in two groups: control (n = 8; 30-50 years; six females, two males) and seniors (n = 8; 75-92 years; six females, two males). After preparation for TEM, the specimens, including epithelium and lamina propria, were examined and photographed at increasing magnification. Results. Control: the epithelium was intact, with overlapped cells, and with desmosomes between the intercellular junctions. The basement membrane was continuous and uniform, and the lamina propria contained collagen and elastic fibers in a regularly distributed loose arrangement, as well as some fibroblasts of different shapes. Senior: the epithelial cells were separated by enlarged intercellular junctions. The basement membrane was delicate and continuous. In the lamina propria there was predominance of elongated fibroblasts. Under the basement membrane a dense network of collagen fibers could be identified. Conclusions. In this study with TEM some structural changes were identified, particularly in the larynx of the elderly, both in the epithelium and lamina propria, some of them with likely participation of fibroblasts, which reinforces the importance of additional ultrastructure as well as molecular studies targeting those cells, as they are the main precursors of the components of the extracellular matrix.

Acoustic characteristics of voice in different cycles of life: an integrative literature review

“…Morphologically, there are changes in the structure of the vocal folds of the elderly. With aging, the diameter of the vocal muscle fibers diminishes, as compared to the adult 32 , the elastic fibers decrease, and a dense and compact network of collagenous fibers forms in the lamina propria, with fibers in the degenerative process 33 . Besides these, there is atrophy of vocal folds in the elderly, and the epithelial cells are separated due to impairment of the intercellular junction 33 .…”

“…With aging, the diameter of the vocal muscle fibers diminishes, as compared to the adult 32 , the elastic fibers decrease, and a dense and compact network of collagenous fibers forms in the lamina propria, with fibers in the degenerative process 33 . Besides these, there is atrophy of vocal folds in the elderly, and the epithelial cells are separated due to impairment of the intercellular junction 33 . In some elderly, there is a concentration of fibroblasts in a dense fibrous matrix of the vocal folds, which affects their flexibility and elasticity, thus bringing vocal alterations in the elderly.…”

“…In the premenstrual period, an increase in shimmer was found in adult women in comparison to the postmenstrual period 22 . In old age, there is an increase in shimmer measurement in the elderly population in relation to the adults 9,29,30 ; it is higher in men, a fact explained by the histologic changes that take place in the elderly's vocal fold, such as decrease in the epithelial thickness of the vocal fold and muscle fibers, in addition to the degeneration present in these fibers 32,33 . Such changes in the mucosa and in the vocal muscle could justify an increase in the perturbation measurements in the elderly population.…”

Injection Laryngoplasty of Human Adipose-derived Stem Cell Spheroids With Hyaluronic Acid-based Hydrogel Improves the Morphological and Functional Characteristics of Geriatric Larynx

“…Among the various causes of geriatric dysphonia, atrophy of the vocal fold (presbylaryngis) has increased rapidly and is attracting considerable attention. The pathophysiology of atrophy involves atrophy and hypotonicity of the vocalis muscles, epithelial atrophy with increased collagen and decreased non brous protein of the extracellular matrix, and deterioration of the framework structure (cartilage and joints) [4,5].…”

Investigação Epidemiológica De Agravos À Saúde Associados a Hábitos Alimentares De Indígenas Idosos

“…Gráfico demonstrativo referente à categorização da população quanto ao sexo Fonte: Os autores Quanto aos dados da escala de sintomas vocais (ESV), foi destacado no momento pós terapia uma redução nos escores totais e nas subescalas (limitação, físico e emocional) (Tabela 2) em todos os participantes.No entanto, apesar desses decréscimos individuais após a intervenção vocal chama-se atenção para a subescala limitação, que teve a maior pontuação tanto no momento pré-terapia quanto no pós terapia. Essa prevalência pode estar relacionada ao impacto das mudanças fisiológicas do envelhecimento na produção vocal e, assim, a comunicação é diretamente afetada MILLES, 2019; ANGERSTEIN, 2018;GONÇALVES;MARTINS;ADRIANA, 2018). De forma semelhante a esse achado, aponta-se que a subescala limitação é apresentada com maior pontuação no público idoso em estudo prévio (QUEIROZ; GOMES; LUCENA, 2019).Sobre as médias do ESV, cabe ressaltar que essa mesma característica decrescente observada no momento pós-terapia também repercutiu nas médias dos escores totais e suas subescalas (Tabela 3).…”