Fibroblasts in the human vocal fold mucosa: an ultrastructural study of different age groups

Awd Allah RS, Dkhil MA, Farhoud E
Correspondence: Dr Mohamed Abdel-Monem Dkhil, mohameddkhil@yahoo.com

ABSTRACT
Introduction An investigation was carried out to determine the morphological characteristics of fibroblasts in two portions of the vocal fold (VF) mucosa, the macula flava (MF) and Reinke’s space (RS), of three different age groups: newborns, adults and geriatrics.
Methods Normal human VF obtained from autopsy cases were included in this study: four from mature newborns; four from middle-aged adults; and four from geriatric cases. Fibroblasts in RS and MF were investigated by transmission electron microscopy.
Results The fibroblasts of the MF in both adults and newborns tended to be stellate in shape, with a small nucleus/cytoplasm (N/C) ratio and a well-developed rough endoplasmic reticulum (rER) and Golgi apparatus (GA). Most of the fibroblasts present in RS were oval in newborns and spindle-shaped in adults, with a large N/C ratio and less developed rER and GA. The majority of fibroblasts of the geriatric MF were stellate in shape; while in geriatric RS, the majority of fibroblasts were spindle-shaped with an N/C ratio of 0.5 to 2.0 as in the case of adults. However, the development of rER and GA was less marked in geriatrics than in adults.
Conclusion Histological changes of fibroblasts in the VF mucosa are one of the important causes of the change in voice quality with ageing. Furthermore, geriatric changes in the vocal ligament can be attributed to the activities and the presence of ageing processes in fibroblasts of geriatric VF mucosa.

Keywords: fibroblasts, human vocal fold mucosa, macula flava, Reinke’s space
Singapore Med J 2009; 50(2): 201-207