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Changes in vocal fold gene expression and histology after injection augmentation in a recurrent laryngeal nerve injury model

Published online by Cambridge University Press:  21 June 2023

Ronit Malka Open the ORCID record for Ronit Malka [Opens in a new window] ,
Alisa Isaac ,
Gabriela Gonzales ,
Solaleh Miar ,
Benjamin Walters ,
Amelia Baker ,
Teja Guda  and
Gregory R Dion
Ronit Malka*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Brooke Army Medical Center, Joint Base San Antonio, Fort Sam Houston, TX, USA
Alisa Isaac
Affiliation:
Department of Biomedical Engineering and Chemical Engineering, University of Texas at San Antonio, San Antonio, TX, USA
Gabriela Gonzales
Affiliation:
Department of Biomedical Engineering and Chemical Engineering, University of Texas at San Antonio, San Antonio, TX, USA
Solaleh Miar
Affiliation:
Department of Civil, Environmental, and Biomedical Engineering, University of Hartford, West Hartford, CT, USA
Benjamin Walters
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Brooke Army Medical Center, Joint Base San Antonio, Fort Sam Houston, TX, USA
Amelia Baker
Affiliation:
Department of Anesthesiology, Brooke Army Medical Center, Joint Base San Antonio, Fort Sam Houston, TX, USA
Teja Guda
Affiliation:
Department of Biomedical Engineering and Chemical Engineering, University of Texas at San Antonio, San Antonio, TX, USA
Gregory R Dion
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Brooke Army Medical Center, Joint Base San Antonio, Fort Sam Houston, TX, USA Department of Otolaryngology – Head and Neck Surgery, University of Cincinnati, Cincinnati, OH, USA
*
Corresponding author: Ronit Malka; Email: ronit.e.malka@gmail.com
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Abstract

Objective

To investigate changes in neuroregenerative pathways with vocal fold denervation in response to vocal fold augmentation.

Methods

Eighteen Yorkshire crossbreed swine underwent left recurrent laryngeal nerve transection, followed by observation or augmentation with carboxymethylcellulose or calcium hydroxyapatite at two weeks. Polymerase chain reaction expression of genes regulating muscle growth (MyoD1, MyoG and FoxO1) and atrophy (FBXO32) were analysed at 4 and 12 weeks post-injection. Thyroarytenoid neuromuscular junction density was quantified using immunohistochemistry.

Results

Denervated vocal folds demonstrated reduced expression of MyoD1, MyoG, FoxO1 and FBXO32, but overexpression after augmentation. Healthy vocal folds showed increased early and late MyoD1, MyoG, FoxO1 and FBXO32 expression in all animals. Neuromuscular junction density had a slower decline in augmented compared to untreated denervated vocal folds, and was significantly reduced in healthy vocal folds contralateral to augmentation.

Conclusion

Injection augmentation may slow neuromuscular degeneration pathways in denervated vocal folds and reduce compensatory remodelling in contralateral healthy vocal folds.

Keywords

Recurrent laryngeal nerve injuryvocal fold paralysismedialization laryngoplastyvocal fold atrophy
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 138 , Issue 2 , February 2024 , pp. 196 - 202
Copyright
Copyright © The Author(s), 2023. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Ronit Malka takes responsibility for the integrity of the content of the paper

Presented at the Fall Voice Conference, 6–8 October 2022, San Francisco, CA, USA.

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