Tissue engineering strategies for vocal fold repair and regeneration

Abstract

Vocal fold is one of the most mechanically active tissues in the human body, producing a great variety of sounds through a regular, wave-like motion of the lamina propria (LP) at frequencies of 100-1,000 Hz and strains up to 30% [1]. Each vocal fold consists of a pliable vibratory layer of connective tissue, known as the lamina propria (LP), sandwiched between epithelium and muscle [2, 3]. The lamina propria plays a critical role in the production of voice as its shape and tension determine the vibratory characteristics of the vocal folds. Numerous environmental factors and pathological conditions can damage the delicate tissue; and patients suffering from vocal fold disorders are socially isolated due to their inability to phonate. This chapter summarizes recent endeavors in vocal fold regeneration using biomaterial-based, tissue engineering methodologies. Successful repair and regeneration of vocal fold lamina propria relies on the attainment of vocal fold-specific, biomimetic matrices that not only foster the attachment and proliferation of vocal fold fibroblast-like cells, but also induce the production of an extracellular matrix (ECM) that approximates the native tissue in terms of the biochemical composition, structural organization, and mechanical characteristics. The performance of the artificial matrices can be further enhanced by incorporating morphogenic factors and physiologically relevant biomechanical stimulations. Strategic combination of polymeric scaffolds, multipotent cells, defined biological factors, and biomechanical signals will lead to the successful reconstruction of functional vocal fold tissues that can be used as an alternative treatment modality for patients suffering from severe vocal fold disorders.