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J Voice. 2021 Feb 01; doi: 10.1016/j.jvoice.2021.01.014. Epub 2021 Feb 01.

Hydration State and Hyaluronidase Treatment Significantly Affect Porcine Vocal Fold Biomechanics.

Journal of voice : official journal of the Voice Foundation

Chenwei Duan, Julian M Jimenez, Craig Goergen, Abigail Cox, Preeti M Sivasankar, Sarah Calve

Affiliations

  1. Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana; Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, Indiana.
  2. Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana; Department of Mechanical Engineering, University of Colorado-Boulder, Boulder, Colorado.
  3. Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana.
  4. Department of Comparative Pathobiology, Purdue University, West Lafayette, Indiana.
  5. Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana; Department of Mechanical Engineering, University of Colorado-Boulder, Boulder, Colorado. Electronic address: [email protected].

PMID: 33541766 PMCID: PMC8325720 DOI: 10.1016/j.jvoice.2021.01.014

Abstract

OBJECTIVES: The understanding of vocal fold hydration state, including dehydrated, euhydrated, rehydrated tissue, and how hydration affects vocal fold biomechanical properties is still evolving. Although clinical observations support the benefits of increasing vocal fold hydration after dehydrating events, more mechanistic information on the effects of vocal fold dehydration and the beneficial effects of rehydration are needed. Alterations to hyaluronic acid (HA), an important component of the vocal fold extracellular matrix, are likely to influence the biomechanical properties of vocal folds. In this study, we investigated the influence of hydration state and HA on vocal fold tissue stiffness via biomechanical testing.

STUDY DESIGN: Prospective, ex vivo study design.

METHODS: Fresh porcine vocal folds (N = 18) were examined following sequential immersion in hypertonic (dehydration) and isotonic solutions (rehydration). In a separate experiment, vocal folds were incubated in hyaluronidase (Hyal) to remove HA. Control tissues were not exposed to any challenges. A custom micromechanical system with a microforce sensing probe was used to measure the force-displacement response. Optical strain was calculated, and ultrasound imaging was used to measure tissue cross-sectional area to obtain stress-strain curves.

RESULTS: Significant increases (P ≤ 0.05) were found in tangent moduli between dehydrated and rehydrated vocal folds at strains of ε = 0.15. The tangent moduli of Hyal-digested tissues significantly increased at both ε = 0.15 and 0.3 (P ≤ 0.05).

CONCLUSION: Vocal fold dehydration increased tissue stiffness and rehydration reduced the stiffness. Loss of HA increased vocal fold stiffness, suggesting a potential mechanical role for HA in euhydrated vocal folds.

Copyright © 2021 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Keywords: Biomechanics; Dehydration; Hyaluronic acid; Rehydration; Vocal folds

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