Hyaluronic acid (with fibronectin) as a bioimplant for the vocal fold mucosa.
OBJECTIVE
To measure the viscoelastic shear properties of hyaluronic acid, with and without fibronectin, and to compare them with those of the human vocal fold mucosa and other phonosurgical biomaterials.


METHODS
Viscoelastic shear properties of various implantable biomaterials (Teflon, gelatin, collagen, fat, hyaluronic acid, and hyaluronic acid with fibronectin) were measured with a parallel-plate rotational rheometer. Elastic and viscous shear properties were quantified as a function of oscillation frequency (0.01-15 Hz) at 37 degrees C.


RESULTS
The shear properties of hyaluronic acid were relatively close to those of human vocal fold mucosal tissues reported previously. Hyaluronic acid at specific concentrations (0.5%-1%), with or without fibronectin, was found to exhibit viscous shear properties (viscous shear modulus and dynamic viscosity) similar to those of the average male and female vocal fold mucosa.


CONCLUSIONS
According to a theory that establishes the effects of tissue shear properties on vocal fold oscillation, phonation threshold pressure (a measure of the ease of phonation) is directly related to the viscous shear modulus of the vibrating vocal fold mucosa. Therefore, our findings suggest that hyaluronic acid, either by itself or mixed with fibronectin, may be a potentially optimal bioimplant for the surgical management of vocal fold mucosal defects and lamina propria deficiencies (e.g., scarring) from a biomechanical standpoint.
National Center for Voice and Speech, Department of Speech Pathology and Audiology, The University of Iowa, Iowa City 52242, USA. roger-chan@uiowa.edu
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Titze
D001672:Biocompatible Materials; D001696:Biomechanical Phenomena; D004548:Elasticity; D005353:Fibronectins; D006801:Humans; D006820:Hyaluronic Acid; D020007:Implants, Experimental; D066298:In Vitro Techniques; D009092:Mucous Membrane; D014783:Viscosity; D014827:Vocal Cords / Q000502:physiology
D001672:Biocompatible Materials; D005353:Fibronectins; D006820:Hyaluronic Acid