2003 Volume 15 Issue 1 Pages 1-10
Vocal fold scarring is one of the most important issues that have remained a therapeutic challenge. It occurs following injury or inflammation, and disrupts the layer structure of the vocal fold lamina propria, which in turn stiffens the vocal fold resulting in severe dysphonia that is difficult to treat. Scarring is histologically characterized by the replacement of normal tissue by fibrosis. Recent investigations have found disorganization of various extracellular matrix (ECM) components such as collagen, elastin, hyaluronic acid, and fibronectin. The key to restore a scarred vocal fold to a normal state is to reorganize ECM in the lamina propria to its normal order. Many therapeutic strategies have been attempted in the treatment of vocal fold scarring including voice therapy, steroid injection, injection laryngoplasty, and framework surgery. The outcomes, however, have turned out to be disappointing. Recently, a new approach has appeared using tissue engineering strategies such as growth factor therapy and cell therapy using stem cell with encouraging results in animal models. Future studies using this approach may shed some light on the treatment of vocal fold scarring.