India ink pinprick assessment of age-related changes in the cricoarytenoid joint (CAJ) articular surfaces

Age-related changes in the articular surfaces of the cricoarytenoid joints (CAJ) of 12 human Caucasian male larynges (6 age 19 to 30 years; 6 age 50 to 80 years) were investigated. Differences in color, roughness, ossification, and surface fiber organization were studied. These were correlated with changes in collagen fiber arrangement on the articular surfaces determined by an India ink pinprick technique. Consistent patterns of orientation of collagen fibers in CAJ surfaces were identified in young and old groups. Older articular surfaces exhibited extensive fibrillation and ossification, suggesting that articular cartilage undergoes alteration in ground substance and/or fiber structure as a function of age. CAJ cartilage changes in older males may limit range of motion of arytenoid cartilages and reduce degree and extent of vocal fold closure. These structural changes may produce negative functional consequences during voice production such as diminished vocal quality and reduced vocal intensity due to air leakage through incompletely or loosely approximated vocal folds.