Tissue engineering for treatment of vocal fold scar

Creating a neovocal fold or lamina propria by tissue engineering is a potential scheme for treating severe vocal fold scar. Although still investigational, multiple approaches have recently been described in tissue culture or animal models.

Proposed cell types for vocal fold application have been native vocal fold fibroblasts, autologous fibroblasts from nonlaryngeal tissues, and adult-derived stem cells. Scaffolds of interest include decellularized matrix, biological polymers, and synthetic or chemically modified biopolymers. Chemical, mechanical, and spatial signals have been applied, such as hepatocyte growth factor, cyclic stretch, and air interface. Cells, matrix, and signals are combined in an effort to replicate normal vocal fold tissue as closely as possible. Each of these components of vocal fold tissue engineering is discussed here.

Multiple tissue engineering approaches hold promise for reproducing functional vocal fold tissue. Scar prevention techniques have been the most successful. Modifying existing scar is more difficult and may necessitate complete scar excision and replacement with a three-dimensional neotissue. Functional assessment in vivo is essential to the ongoing evaluation of techniques.