title: Distribution of collagen in the lamina propria of the human vocal fold.
abstract: OBJECTIVE
  To describe the arrangement of collagen fibers in the lamina propria of the human vocal fold.
  
  
  METHODS
  Analysis of the lamina propria of the vocal fold obtained from human cadavers.
  
  
  METHODS
  The Picrosirius-polarization method was used to visualize collagen fibers.
  
  
  RESULTS
  Analysis of 20 human vocal folds by the Picrosirius-polarization method permitted the visualization of two fiber populations arranged in three layers in the lamina propria: two layers of thick, strongly birefringent collagen fibers (collagen type I), one immediately below the epithelium and another more dense layer in the deep region superficially to the vocal muscle, penetrating between muscle fibers. The third layer consisted of fine, weakly birefringent fibers (collagen type III) located between the two layers of thick fibers. In addition, the collagen fibers in the lamina propria showed an intertwined network arrangement in the form of a "wicker basket."
  
  
  CONCLUSIONS
  This basket-like configuration better explains how the vocal fold is able to stretch even though it contains nonstretchable fibers and to modulate the frequency of the voice under the action of the intrinsic musculature of the larynx. Segmental areas of disarray of the basket-like structure of the collagen layers were systematically observed in older patients. Thus, it is possible that vocal alterations occurring in the elderly might be the result of a loss of histoarchitectural arrangement of the collagen system and its relationship with the lamina propria and underlying musculature.
authors.affiliation: Department of Otolaryngology, University of São Paulo School of Medicine, São Paulo, Brazil. erichmelo@uol.com.br
authors.forename: Erich Christiano
authors.initials: EC
authors.lastname: Madruga de Melo
authors.forename: Miriam
authors.initials: M
authors.lastname: Lemos
authors.forename: João
authors.initials: J
authors.lastname: Aragão Ximenes Filho
authors.forename: Luiz Ubirajara
authors.initials: LU
authors.lastname: Sennes
authors.forename: Paulo Hilário
authors.initials: PH
authors.lastname: Nascimento Saldiva
authors.forename: Domingos Hiroshi
authors.initials: DH
authors.lastname: Tsuji
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology; D002102:Cadaver; D003094:Collagen / Q000648:ultrastructure*; D024042:Collagen Type I / Q000648:ultrastructure; D024061:Collagen Type III / Q000648:ultrastructure; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000737:chemistry; D014018:Tissue Distribution; D014827:Vocal Cords / Q000737:chemistry*
chemical_list: D024042:Collagen Type I; D024061:Collagen Type III; D003094:Collagen