Vocal Fold Epithelial Barrier in Health and Injury: A Research Review Purpose Vocal fold epithelium is composed of layers of individual epithelial cells joined by junctional complexes constituting a unique interface with the external environment. This barrier provides structural stability to the vocal folds and protects underlying connective tissue from injury while being nearly continuously exposed to potentially hazardous insults, including ... Review
Review  |   October 01, 2014
Vocal Fold Epithelial Barrier in Health and Injury: A Research Review
 
Author Affiliations & Notes
  • Elizabeth Erickson Levendoski
    University of Wisconsin—Madison
  • Ciara Leydon
    University of Wisconsin—Madison
  • Susan L. Thibeault
    University of Wisconsin—Madison
  • Disclosure: The authors have declared that no competing interests existed at the time of publication.
    Disclosure: The authors have declared that no competing interests existed at the time of publication.×
  • Correspondence to Susan L. Thibeault: thibeault@surgery.wisc.edu
  • Editor: Jody Kreiman
    Editor: Jody Kreiman×
  • Associate Editor: Jennifer Long
    Associate Editor: Jennifer Long×
Article Information
Speech, Voice & Prosody / Speech / Review
Review   |   October 01, 2014
Vocal Fold Epithelial Barrier in Health and Injury: A Research Review
Journal of Speech, Language, and Hearing Research, October 2014, Vol. 57, 1679-1691. doi:10.1044/2014_JSLHR-S-13-0283
History: Received October 17, 2013 , Revised January 19, 2014 , Accepted March 4, 2014
 
Journal of Speech, Language, and Hearing Research, October 2014, Vol. 57, 1679-1691. doi:10.1044/2014_JSLHR-S-13-0283
History: Received October 17, 2013; Revised January 19, 2014; Accepted March 4, 2014
Web of Science® Times Cited: 13

Purpose Vocal fold epithelium is composed of layers of individual epithelial cells joined by junctional complexes constituting a unique interface with the external environment. This barrier provides structural stability to the vocal folds and protects underlying connective tissue from injury while being nearly continuously exposed to potentially hazardous insults, including environmental or systemic-based irritants such as pollutants and reflux, surgical procedures, and vibratory trauma. Small disruptions in the epithelial barrier may have a large impact on susceptibility to injury and overall vocal health. The purpose of this article is to provide a broad-based review of current knowledge of the vocal fold epithelial barrier.

Method A comprehensive review of the literature was conducted. Details of the structure of the vocal fold epithelial barrier are presented and evaluated in the context of function in injury and pathology. The importance of the epithelial-associated vocal fold mucus barrier is also introduced.

Results/Conclusions Information presented in this review is valuable for clinicians and researchers as it highlights the importance of this understudied portion of the vocal folds to overall vocal health and disease. Prevention and treatment of injury to the epithelial barrier is a significant area awaiting further investigation.

Acknowledgments
This work was supported by National Institute on Deafness and Other Communication Disorders Grants R01 DC012773, R03 DC011355, and T32 DC009401. We thank Anna Pankratz for assistance during illustration preparation.
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