Collagen microstructure in the vocal ligament: Initial results on the potential effects of smoking

Objectives/Hypothesis This investigation quantitatively characterizes the collagenous microstructure of human vocal ligament specimens excised postmortem from nonsmokers and smokers. Study Design Retrospective cohort study. Methods Second harmonic generation (SHG) imaging was performed at three anatomical locations of vocal ligament specimens: anterior, mid-membranous, and posterior regions. Two microstructural parameters were extracted from the SHG images: (1) normalized fiber density, and (2) fiber dispersion coefficient, quantifying the degree of collagen fiber dispersion about a preferred direction. Results For both the nonsmoker and smoker subjects, the fiber dispersion coefficient was heterogeneous. Differences in the collagenous structure of nonsmokers and smoker subjects were pronounced at the mid-membranous location. However, the directionality of the heterogeneity in the smoker subjects was opposite to that in the nonsmoker subjects. Specifically, the fiber dispersion coefficient in the nonsmoker subjects was lower in the mid-membranous region (indicating more fiber alignment) than at the anterior/posterior regions, but for the smoker subjects the fiber dispersion coefficient was higher at the mid-membranous region. The normalized fiber density was near constant in the nonsmoker subjects, but the smoker subjects had fewer fibers in the mid-membranous region than at the anterior/posterior regions. Conclusion Spatial microstructural variations may exist in the vocal fold ligament both in nonsmokers and smokers. Smoking appears to influence the degree and direction of microstructure heterogeneity in the vocal fold ligament. Level of Evidence N/A.