Vocal Fold Scar

Abstract

Connective tissue repair involves a well-orchestrated cascade of events which progresses through four distinct yet overlapping phases: (1) homeostasis, (2) inflammation, (3) proliferation, and (4) maturation. Pathological scarring occurs when some aspect of the healing cascade is disrupted or continues unchecked. Children and adolescents who present with chronic vocal fold scarring frequently have extensive and complex medical histories. Those at particular risk for developing vocal fold scar include individuals with a history of juvenile-onset recurrent respiratory papillomatosis, prolonged intubation and/or upper airway reconstruction, laryngeal web, mass lesions involving the vocal ligament, and-while rare-laryngeal cancer. Current treatment options may not be completely effective in recovering premorbid vocal function; however, early voice therapy is critical for developing optimal voice behaviors and preventing the development of negative compensatory strategies. Surgical interventions have been developed to release scarred tissues and improve vibratory function, and emerging research in tissue regeneration to restore the premorbid structure of the lamina propria is promising and may provide an effective treatment for a challenging disorder.