Bioengineering the Vocal Fold: A Review of Mesenchymal Stem Cell Applications

Abstract

The vocal folds are a remarkably unique tissue in the body, in that they can produce vibration at rates between 100-1000 hertz throughout the course of a day (Guimaraes & Abberton, 2005; Hunter et al., 2006). When this robust tissue is disrupted by scarring associated with vocal fold lesion excision, carcinoma, radiation, trauma, or inflammatory disease, the associated degradation in vocal quality can be devastating. More than half of individuals with voice disorders attribute their dysphonia as having a negative impact on their social interactions, career and mental health (Smith et al., 1995). Traditional surgical treatments and voice therapy have been suboptimal for improving the dysphonia and fatigue associated with vocal fold scarring (Hansen & Thibeault, 2006). Over the past decade, a number of promising pre-clinical studies targeted at vocal fold regeneration using mesenchymal stem cells (MSCs) have been completed. As nearly all of the dedicated stem cell investigation has been completed in vitro and in animal models, there exists a great opportunity for innovation and landmark work in the future of this field. Our intention is to present the therapeutic interventions explored in the literature to date for mesenchymal stem cell (MSC) based approaches for vocal fold regeneration, in order to inform optimal approaches of the future.