Histopathologic changes in human true vocal folds: a postmortem study

Several articles describe the gross pathology alterations of the true vocal cords (TVC), but the histopathology descriptions in adults are rare in the literature and are normally associated with neoplasia. The aim of this study is to identify the TVC morphological lesions in adult autopsies. This was a cross-sectional study of 266 adults' larynxes consecutively autopsied from 1993 to 2003. Histochemical and immunohistochemical methods were used for morphological analysis. Considering the morphological analysis, 97 TVC (36.5%) were considered normal. The following lesions were found in the TVC: thickening of the basal membrane of the TVC in 81 patients (30.5%), inflammatory reaction in 66 patients (24.8%), hemorrhage in 19 patients (7.1%), and ulceration in 3 patients (1.1%). Our study demonstrated that the TVC microscopic lesions are frequent, present different morphological patterns, and showed different causes from what had been described until nowadays by the literature. Despite this difference in the morphological pattern, we were able to identify a common lesion pathway for ethiological different diseases.