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Laryngoscope. 2009 Sep;119(9):1856-63. doi: 10.1002/lary.20575.

Liver-derived extracellular matrix as a biologic scaffold for acute vocal fold repair in a canine model.

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McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15219, USA.



The objective of the study was to evaluate a naturally derived liver extracellular matrix (L-ECM) scaffold for repair of an acute injury to the vocal fold lamina propria in a canine model.


The vocal fold lamina propria was removed bilaterally in four dogs. One vocal fold in each dog was repaired with a porcine L-ECM scaffold, which was chosen because it contains hepatocyte growth factor, an antifibrotic growth factor that aids the healing of vocal folds. The other vocal fold was left untreated. At 3 months after surgery, morphologic and histologic analysis was performed to assess the vocal fold shape, collagen density, collagen composition, elastic fiber content, and glycosaminoglycan content.


The L-ECM-treated vocal fold showed increased collagen density in the superficial aspect of the vocal fold (P < .05). The L-ECM-treated vocal fold also showed an increased collagen III/I ratio as compared to the nontreated group (P < .05). However, the elastic fiber content was found to be increased in both groups, and the glycosaminoglycan content was decreased in both groups as compared to the normal vocal fold (P < .05) with no differences detected between groups.


The L-ECM scaffold did not restore the biochemical composition or histologic appearance of the injured vocal fold as compared to normal. However, the increased ratio of collagen III/I and elastic fiber content suggests that L-ECM leads to formation of connective tissue that may be more pliable as compared to no treatment. Additional investigation, including functional assessment, is warranted.

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