title: Advances in our understanding of the Reinke space.
abstract: OBJECTIVE
  Normal vocal fold vibration depends critically upon the composition of the Reinke space or the lamina propria extracellular matrix. Alterations in the normal composition of the extracellular matrix result in a loss of normal vibratory function. In this article, the present literature on the Reinke space in normal and disease states is reviewed including publications in the multidisciplinary fields of biomechanics, histology, molecular biology, and tissue engineering.
  
  
  RESULTS
  With recent technology advances, the etiology for benign lesions has been investigated with computer models and bioreactors. Particular extracellular matrix constituents in various benign vocal fold lesions--fibronectin, fibromodulin and hyaluronan--appear to be involved in altering the viscoelastic properties of the Reinke space. Significant basic science approaches to the investigation of the characterization of the Reinke space in vocal fold scarring has produced several potential future treatment avenues. Tissue-engineering approaches for regeneration of the Reinke space are the most recent addition to the literature showing promising research directions.
  
  
  CONCLUSIONS
  Voice disorders represent a significant clinical problem. Research attempting to discover the underlying molecular and genetic regulation and homeostasis of the extracellular matrix of the Reinke space are essential. Effective future clinical interventions must be based upon the knowledge of how genetic and biologic features are disturbed in vocal diseases and how they relate to vocal symptoms.
authors.affiliation: The University of Utah, Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, School of Medicine, Salt Lake City, Utah 84132-2301, USA. susan.thibeault@hsc.utah.edu
authors.forename: Susan L
authors.initials: SL
authors.lastname: Thibeault
mesh_terms: D001696:Biomechanical Phenomena; D015153:Blotting, Western; D004548:Elasticity; D004797:Enzyme-Linked Immunosorbent Assay; D005109:Extracellular Matrix / Q000378:metabolism*; D016326:Extracellular Matrix Proteins / Q000378:metabolism*; D000071235:Fibromodulin; D005353:Fibronectins / Q000378:metabolism*; D006801:Humans; D006820:Hyaluronic Acid / Q000378:metabolism*; D016133:Polymerase Chain Reaction; D011509:Proteoglycans / Q000378:metabolism*; D023822:Tissue Engineering; D014732:Vibration; D014783:Viscosity; D014827:Vocal Cords / Q000378:metabolism*; D014832:Voice Disorders / Q000453:epidemiology / Q000503:physiopathology
chemical_list: D016326:Extracellular Matrix Proteins; C000604330:FMOD protein, human; D005353:Fibronectins; D011509:Proteoglycans; D000071235:Fibromodulin; D006820:Hyaluronic Acid