Effects of repeated stripping on vocal fold mucosa in cats

Repeated stripping of the vocal folds in patients with recurrent vocal nodules may produce permanent, negative effects on voice quality. Hoarseness can be present with no evidence of structural or functional disease on indirect laryngoscopy. A common assumption is that scar tissue has formed, though the relationship between scarring and voice quality is not clear. In the study reported here, cats were subjected to four strippings of the left vocal fold at 6- to 8-week intervals. Tissues obtained were examined for changes in the composition of the mucosa and its nervous network. Alterations observed over the four strippings included 1) an increasing component of fibrous tissue and 2) apparent changes in both the number and structure of nervous elements. Implications of the findings for voice production, clinical management, and further research are discussed.