Age-related development of the arrangement of connective tissue fibers in the lamina propria of the human vocal fold.

A scanning electron microscopic study was made on the morphological changes occurring with age in collagen and elastic fibers in the lamina propria of the human vocal fold. We obtained the specimens from 32 autopsy cases ranging from 20 gestational weeks to 22 postnatal years and submitted them to digestion treatments with 10% sodium hydroxide and 90% formic acid. The vocal folds in fetuses and neonates consisted of sparse and dense areas of collagen and elastic fibers, and the vocal ligament was not found. In subjects 5 years of age, a deep dense area was found in the anterior and posterior maculae flavae, and longitudinal fibers were noted between the maculae. A structure of superficial versus deep layers appeared in children older than 10 years of age. The layered structure of the lamina propria was complete around 17 years of age. The development of the layered structure and the maturity of the fibers appeared to reflect the complexity of phonatory function during adolescence.