Sunday, May 5, 2024
5/5/2024
Project Summary Vocal fold scarring results in voice dysfunction and decreased quality of life for patients. With around 20 million people impacted by voice disorders each year, and vocal fold scar a common cause of this dysphonia with few effective treatments available, new, novel treatment approaches are needed. Currently, one of the primary challenges to treatment is wound healing optimization in the dynamic, delicate vocal fold multi-layer structure. Although surgical repair can be employed for vocal fold scar treatment, current surgical techniques often result in subsequent scarring. Adjuvant local therapeutic delivery, most commonly with corticosteroids, is often used to improve wound healing; however, limited access to the vocal folds generally restricts providers to a single therapeutic injection at the time of surgery. In-office procedures exist for subsequent therapeutic vocal fold injections, though these are uncomfortable for patients and increase treatment costs. Oral corticosteroids are not an effective alternative, as research has found them less effective than local application and with more side effects. Additional novel biologics have been proposed for vocal fold scar treatment, though these are also limited by similar delivery problems to corticosteroids. We have found that a novel, injectable encapsulated implant can deliver corticosteroids over time either in a sustained release fashion or in a laser-light activated approach effectively for up to eight months in a leporine eye preclinical model. In prior work, we found minimal immune response or unanticipated drug leakage from the injectable implant in the leporine eye. In parallel, we have optimized vocal fold biomechanical quantification matched to histology after vocal fold injuries. In the first aim, we will optimize our injectable implant for the vocal folds and measure any local immune response in healthy leporine vocal folds. In the second aim, we will employ the implant in a vocal fold injury model to quantify its healing impacts compared to no treatment or traditional single corticosteroid injections. This work lays the foundation for optimized, dose controllable therapeutic delivery to the vocal folds and improved drug delivery.
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