title: Vocal fold surface hydration: a review.
abstract: Vocal fold surface liquid homeostasis contributes to optimal vocal physiology. In this paper we review emerging evidence that vocal fold surface liquid is maintained in part by salt and water fluxes across the epithelium. Based on recent immunolocalization and electrophysiological findings, we describe a transcellular pathway as one mechanism for regulating superficial vocal fold hydration. We propose that the pathway includes the sodium-potassium pump, sodium-potassium-chloride cotransporter, epithelial sodium channels, cystic fibrosis transmembrane regulator chloride channels, and aquaporin water channels. By integrating knowledge of the regulating mechanisms underlying ion and fluid transport with observations from hydration challenges and treatments using in vitro and in vivo studies, we provide a theoretical basis for understanding how environmental and behavioral challenges and clinical interventions may modify vocal fold surface liquid composition. We present converging evidence that clinical protocols directed at facilitating vocal fold epithelial ion and fluid transport may benefit healthy speakers, those with voice disorders, and those at risk for voice disorders.
authors.affiliation: Department of Speech Communication Arts and Sciences, Brooklyn College of The City University of New York, New York 12110, USA. cleydon@brooklyn.cuny.edu
authors.forename: Ciara
authors.initials: C
authors.lastname: Leydon
authors.forename: Mahalakshmi
authors.initials: M
authors.lastname: Sivasankar
authors.forename: Danielle Lodewyck
authors.initials: DL
authors.lastname: Falciglia
authors.forename: Christopher
authors.initials: C
authors.lastname: Atkins
authors.forename: Kimberly V
authors.initials: KV
authors.lastname: Fisher
mesh_terms: D000818:Animals; D006801:Humans; D017136:Ion Transport / Q000187:drug effects / Q000502:physiology; D007820:Laryngeal Mucosa / Q000187:drug effects / Q000502:physiology*; D014827:Vocal Cords / Q000187:drug effects / Q000502:physiology*; D014831:Voice / Q000187:drug effects / Q000502:physiology; D014867:Water / Q000378:metabolism*
chemical_list: D014867:Water