title: Treatment of aging vocal folds: novel approaches.
abstract: OBJECTIVE
  This article aims to review previous research reports and to summarize current strategies for the treatment of the aging vocal fold using regenerative medicine and tissue engineering, with a particular focus on growth factor therapy.
  
  
  RESULTS
  Previous studies have elucidated age-related histological and gene expression changes in key extracellular matrix components, such as collagen and hyaluronan, in the lamina propria of the aging vocal fold. On the basis of these findings, our research group has focused on growth factor therapy to restore extracellular matrix distribution in the aging vocal fold to a younger state. Results from recent studies with basic fibroblast growth factor and hepatocyte growth factor provided preliminary evidence of the regenerative effects of growth factor therapy on treatment of the aging vocal fold. In addition, a clinical trial using basic fibroblast growth factor revealed improvements of maximum phonation time, mean flow rate, and acoustic parameters in atrophied vocal folds. These positive findings suggest that the administration of basic fibroblast growth factor may become a useful tool for the treatment of the aging vocal fold.
  
  
  CONCLUSIONS
  Regenerative medicine and tissue engineering are innovative strategies for the treatment of aging vocal folds, and recent reports have also confirmed the therapeutic potential of growth factor therapy for the treatment of the aging vocal fold. More recently, the clinical application of basic fibroblast growth factor was reported with encouraging outcomes. Continued basic research and clinical investigations will be required to develop strategies to overcome age-related voice disorders.
authors.affiliation: aDepartment of Otolaryngology-Head and Neck Surgery, Kurashiki Central Hospital, Kurashiki, Japan bDepartment of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Tsunehisa
authors.initials: T
authors.lastname: Ohno
authors.forename: Shigeru
authors.initials: S
authors.lastname: Hirano
mesh_terms: D000375:Aging / Q000473:pathology*; D000818:Animals; D005109:Extracellular Matrix / Q000473:pathology; D016222:Fibroblast Growth Factor 2 / Q000627:therapeutic use*; D017228:Hepatocyte Growth Factor / Q000627:therapeutic use*; D006801:Humans; D010699:Phonation / Q000187:drug effects; D023822:Tissue Engineering / Q000379:methods*; D014827:Vocal Cords / Q000473:pathology*; D014832:Voice Disorders / Q000473:pathology* / Q000628:therapy*; D014833:Voice Quality
chemical_list: D016222:Fibroblast Growth Factor 2; D017228:Hepatocyte Growth Factor