The Effect of Fibroblast Growth Factors in Grafted Fascia into the Vocal Fold of Rabbits
01 September 2017
08 May 2018
05 July 2018 (online)
Introduction The human larynx is a very important organ for communication. Many conditions lead to scarring of the vocal folds, decreasing voice quality.
Objective We aimed to determine whether fibroblast growth factors (FGFs) may influence tissue integration of grafted fascia into the vocal folds of an animal model.
Methods This is an experimental animal study with 12 adult rabbits that were submitted to a grafting fragment obtained from superficial cervical fascia into the vocal fold lamina propria, bilaterally. The right vocal fold was injected with FGFs. The animals were sacrificed after 1 month or 12 months, depending on the group they were assigned to, and a histological analysis of their vocal folds was performed. We analyzed the histological changes (such as the presence of fibrosis and neovascularization) induced by the acute or chronic inflammatory reactions.
Results The FGFs induced acute inflammatory changes in all animals after 1 month of the initial experiment. The presence of FGFs triggered more fibrosis than the expected due to the surgical procedure itself when compared with the control side of all animals after 12 months of the initial experiment.
Conclusions Fibroblast growth factors alone do not represent a good therapeutic option in phonosurgery, since we observed higher levels of fibrosis in the vocal fold lamina propria. Further studies combining more substances may be necessary to elucidate the best option to be used in this kind of surgery.
- 1 Kishimoto Y, Hirano S, Suehiro A. , et al. Effect of exogenous hepatocyte growth factor on vocal fold fibroblasts. Ann Otol Rhinol Laryngol 2009; 118 (08) 606-611
- 2 Hirano M, Yoshida T, Tanaka S, Hibi S. Sulcus vocalis: functional aspects. Ann Otol Rhinol Laryngol 1990; 99 (9 Pt 1): 679-683
- 3 Lindestad PA, Hertegård S. Spindle-shaped glottal insufficiency with and without sulcus vocalis: a retrospective study. Ann Otol Rhinol Laryngol 1994; 103 (07) 547-553
- 4 Sato K, Hirano M, Nakashima T. Fine structure of the human newborn and infant vocal fold mucosae. Ann Otol Rhinol Laryngol 2001; 110 (5 Pt 1): 417-424
- 5 Hirano S, Bless DM, Heisey D, Ford CN. Effect of growth factors on hyaluronan production by canine vocal fold fibroblasts. Ann Otol Rhinol Laryngol 2003; 112 (07) 617-624
- 6 Hirano S, Bless DM, Rousseau B. , et al. Fibronectin and adhesion molecules on canine scared vocal folds. Laryngoscope 2003; 113: 969-972
- 7 Ohno T, French LC, Hirano S, Ossoff RH, Rousseau B. Effect of hepatocyte growth factor on gene expression of extracellular matrix during wound healing of the injured rat vocal fold. Ann Otol Rhinol Laryngol 2008; 117 (09) 696-702
- 8 Hirano S, Bless DM, Massey RJ, Hartig GK, Ford CN. Morphological and functional changes of human vocal fold fibroblasts with hepatocyte growth factor. Ann Otol Rhinol Laryngol 2003; 112 (12) 1026-1033
- 9 Kanemaru S, Nakamura T, Omori K. , et al. Regeneration of the vocal fold using autologous mesenchymal stem cells. Ann Otol Rhinol Laryngol 2003; 112 (11) 915-920
- 10 Luo Y, Kobler JB, Zeitels SM, Langer R. Effects of growth factors on extracellular matrix production by vocal fold fibroblasts in 3-dimensional culture. Tissue Eng 2006; 12 (12) 3365-3374
- 11 Thibeault SL, Rousseau B, Welham NV, Hirano S, Bless DM. Hyaluronan levels in acute vocal fold scar. Laryngoscope 2004; 114 (04) 760-764
- 12 Ornitz DM, Itoh N. The fibroblast growth factor signalling pathway. Wiley Interdiscip Rev Dev Biol 2015; 4 (03) 215-266
- 13 Chan RW, Titze IR. Viscosities of implantable biomaterials in vocal fold augmentation surgery. Laryngoscope 1998; 108 (05) 725-731
- 14 Chan RW, Titze IR. Hyaluronic acid (with fibronectin) as a bioimplant for the vocal fold mucosa. Laryngoscope 1999; 109 (7 Pt 1): 1142-1149
- 15 Hallén L, Testad P, Sederholm E, Dahlqvist A, Laurent C. DiHA (dextranomers in hyaluronan) injections for treatment of insufficient closure of the vocal folds: early clinical experiences. Laryngoscope 2001; 111 (06) 1063-1067
- 16 Rosen CA. Vocal fold scar: evaluation and treatment. Otolaryngol Clin North Am 2000; 33 (05) 1081-1086
- 17 Woo P, Rahbar R, Wang Z. Fat implantation into Reinke's space: a histologic and stroboscopic study in the canine. Ann Otol Rhinol Laryngol 1999; 108 (08) 738-744
- 18 Rihkanen H. Vocal fold augmentation by injection of autologous fascia. Laryngoscope 1998; 108 (1 Pt 1): 51-54
- 19 Reijonen P, Leivo I, Nevalainen T, Rihkanen H. Histology of injected autologous fascia in the paralyzed canine vocal fold. Laryngoscope 2001; 111 (06) 1068-1074
- 20 Tsunoda K, Takanosawa M, Niimi S. Autologous transplantation of fascia into the vocal fold: a new phonosurgical technique for glottal incompetence. Laryngoscope 1999; 109 (03) 504-508
- 21 Tsunoda K, Niimi S. Autologous transplantation of fascia into the vocal fold. Laryngoscope 2000; 110 (04) 680-682
- 22 Hirano S, Kishimoto Y, Suehiro A, Kanemaru S, Ito J. Regeneration of aged vocal fold: first human case treated with fibroblast growth factor. Laryngoscope 2008; 118 (12) 2254-2259
- 23 Akdogan O, Selcuk A, Ozcan I. , et al. Activation of vocal fold healing with topical vitamin A in rabbits. Acta Otolaryngol 2009; 129 (02) 220-224
- 24 de Giacomo Carneiro C, Sennes LU, Saldiva PHN, Tsuji DH, Ximenes Filho JA. Assessment of collagen deposits after implant of fascia lata and fat in the vocal folds of rabbits: histomorphometric study. Rev Bras Otorrinolaringol (Engl Ed) 2005; 71 (06) 798-802
- 25 Krishna P, Rosen CA, Branski RC, Wells A, Hebda PA. Primed fibroblasts and exogenous decorin: potential treatments for subacute vocal fold scar. Otolaryngol Head Neck Surg 2006; 135 (06) 937-945
- 26 Robins SL, Cotran RS, Kumar VM. Acute and chronic inflammation. In: Robins SL, Cotran RS, Kumar VM. , eds. Structural and functional pathology. Rio de Janeiro, RJ: Ed. Guanabara; 1886: 680-696
- 27 Duke SG, Salmon J, Blalock PD, Postma GN, Koufman JA. Fascia augmentation of the vocal fold: graft yield in the canine and preliminary clinical experience. Laryngoscope 2001; 111 (05) 759-764
- 28 Branski RC, Barbieri SS, Weksler BB. , et al. Effects of transforming growth factor-beta1 on human vocal fold fibroblasts. Ann Otol Rhinol Laryngol 2009; 118 (03) 218-226
- 29 Scapini F, da Silva LF, Tsuji DH, Dolhnikoff M, Sennes LU. Effect of fibrin glue on collagen deposition after autologous fascia grafting in rabbit vocal folds. Ann Otol Rhinol Laryngol 2011; 120 (10) 663-668
- 30 Rousseau B, Hirano S, Chan RW. , et al. Characterization of chronic vocal fold scarring in a rabbit model. J Voice 2004; 18 (01) 116-124
- 31 Thibeault SL, Gray SD, Bless DM, Chan RW, Ford CN. Histologic and rheologic characterization of vocal fold scarring. J Voice 2002; 16 (01) 96-104