The unsolved chapter of vocal fold scars and how tissue engineering could help us solve the problem

Area of Science:

• Regenerative Medicine
• Biomaterials Science
• Otorhinolaryngology

Background:

• Vocal fold scarring results from microstructural damage, leading to persistent hoarseness and breathy voice.
• Current tissue engineering strategies show promise but lack routine clinical application.
• Vocal fold fibroblasts, key to fibrogenesis, possess poorly characterized properties crucial for therapeutic development.

Purpose of the Study:

• To highlight the unique challenges in vocal fold scar research.
• To emphasize the need for better characterization of vocal fold fibroblasts.
• To advocate for the development of representative in vitro models for therapeutic innovation.

Main Methods:

• Review of current literature on vocal fold scarring and tissue engineering.
• Discussion of the specific properties of vocal fold fibroblasts.
• Exploration of innovative in vitro strategies like macro-molecular crowding.

Main Results:

• Vocal fold scarring significantly impacts vocal fold vibration and voice quality.
• Existing in vitro models do not adequately represent the vocal fold environment.
• Macro-molecular crowding emerges as a promising strategy for in vitro modeling.

Conclusions:

• Further research into vocal fold fibroblast biology is essential for effective scar treatment.
• Development of advanced in vitro models is critical to overcome limitations of in vivo studies.
• Innovative approaches like macro-molecular crowding could advance vocal fold regenerative medicine.