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Prolonged phonation impairs the integrity and barrier function of porcine vocal fold epithelium: a preliminary study

  • Laryngology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

Voice abuse is known to be a common risk factor of voice disorders and prolonged; high-intensity phonation has been shown to damage the vocal fold epithelium. We aim to evaluate the effects of phonation on the integrity and barrier function of vocal fold epithelium using a porcine laryngeal model.

Methods

Ex vivo porcine larynges were phonated at low intensity or high intensity for 15, 30, or 60 min within 4 h after harvest. Vocal fold epithelium was visualized using transmission electron microscopy (TEM). The barrier function of vocal fold epithelium was evaluated by measuring the permeability to model molecules, fluorescein (376 Da), and fluorescein isothiocyanate (FITC)–dextrans of 4000 and 10,000 Da (FD4, FD10), in a Franz diffusing cell.

Results

Cell death and dilated intercellular space after phonation were observed using TEM. Thickness of vocal fold epithelium was significantly reduced after low-intensity phonation for 30 and 60 min and high-intensity phonation for 15, 30, and 60 min. Epithelial permeability to fluorescein was significantly increased after low-intensity phonation for 30 and 60 min, and high-intensity phonation. Permeability to FD4 was significantly increased after high-intensity phonation for 30 and 60 min. Phonation did not alter the permeability to FD10 significantly.

Conclusion

Long-duration phonation destroys the integrity and barrier function of vocal fold epithelium. These effects likely make vocal folds more vulnerable to other environmental irritants, such as tobacco smoke, reflux components, allergens, and inhaled pollutants. Destroyed barrier function may be an important factor in the pathogenesis of voice lesions related to voice abuse.

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Acknowledgements

This work was supported by the grant from the National Natural Science Foundation of China, Project 81329001.

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Authors and Affiliations

  1. Department of Otolaryngology-Head and Neck Surgery, Eye, Ear, Nose, and Throat Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031, China

    Chi Zhang, Ting Gong & Jack J. Jiang

  2. Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, 53792, USA

    Kieran Paddock, Adriana Chou, Austin Scholp & Jack J. Jiang

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  1. Chi Zhang
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Correspondence to Jack J. Jiang.

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This article does not contain any studies with live animals or human participants performed by any of the authors. Tissue was procured from animal cadavers and sacrificed for reasons unrelated to this research.

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Zhang, C., Paddock, K., Chou, A. et al. Prolonged phonation impairs the integrity and barrier function of porcine vocal fold epithelium: a preliminary study. Eur Arch Otorhinolaryngol 275, 1547–1556 (2018). https://doi.org/10.1007/s00405-018-4973-9

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  • DOI: https://doi.org/10.1007/s00405-018-4973-9

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