Gender-related differences of hyaluronic acid distribution in the human vocal fold
Gender-related differences of hyaluronic acid distribution in the human vocal fold
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DOI：
10.1097/00005537-200105000-00029
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发表时间：
2001-05-01
期刊：
影响因子：
2.6
通讯作者：
Gray, SD
中科院分区：
文献类型：
--
作者：
Butler, JE;Hammond, TH;Gray, SD
目的：量化透明质酸(HA)在正常人声带中的分布，并评价其在性别和年龄上的差异。研究设计：按年龄和性别分组的前瞻性横断面研究，使用身体声带研究透明质酸的差异。方法：选取成年男性9例(年龄34~52岁)、成年女性7例(年龄21~41岁)、老年男性4例(年龄65~77岁)、老年女性5例(年龄65~82岁)，采用含透明质酸酶和不含透明质酸酶的Muller-Mowry胶体铁(酸性粘多糖)染色方法对25例声带标本的中膜切片进行透明质酸染色，用数字成像软件定量分析HA在声带边缘浅(上皮下)至深层(声带肌肉)的分布。结果：在控制年龄的情况下，性别差异显著(P=.03)。合并后，男性受试者固有层深度具有相对恒定的分布模式，女性受试者在前15%的深度(最浅)的HA相对较少，但在更深的40%至100%(向声门肌肉)的HA比男性受试者高。结论：从我们的发现中可以推断出重要的临床意义。首先，在最浅的区域相对较少的HA意味着对振动创伤和过度使用的保护较少，这可能部分解释了为什么女性患者比男性患者更多的声音创伤到声音创伤损害。其次，评估HA在正常人声带中的分布可以为我们将HA作为治疗嗓音障碍患者固有层替代品的应用提供更多指导。
Objective: To quantify the distribution of hyaluronic acid (HA) within the normal human vocal fold and evaluate gender- and age-related differences. Study Design: Prospective, cross-sectional study by age and gender groups using cadaveric vocal folds to study hyaluronic acid differences. Methods:Twenty-five vocal fold halves obtained at autopsy were evaluated from nine adult male (age range, 34-52 y), seven adult female (age range, 21-41 y), four geriatric male (age range, 65-77 y), and five geriatric female (age range 65-82 y) subjects, Midmembranous vocal fold sections were stained for HA using the Muller-Mowry colloidal iron (acid mucopolysaccharide) stain with and without hyaluronidase, Digital imaging software was used to quantify the distribution of HA across the lamina propria at the vocal fold edge from superficial (subepithelial) to deep (vocalis muscle). Results: A significant gender difference (P =.03) was noted in distribution when controlled for age. Combined, male subjects had a relatively constant distribution pattern throughout the depth of lamina propria, Female subjects showed relatively less HA in the first 15% of depth (most superficial) but showed more HA in the deeper 40% to 100% (toward vocalis muscle) than in male subjects. Conclusions: Important clinical implications may be extrapolated from our findings. First, relatively less HA in the most superficial area implies less protection from vibratory trauma and overuse and may explain in part why more female than male patients have phonotrauma to phonotraumatic lesions. Second, evaluating the distribution of HA in the normal human vocal fold allows more direction in our application of HA as a therapeutic lamina propria substitute in patients with voice disorders.