New-Found Hope To Those With No Voice

Following a surgery which involved removal of noncancerous lesions from her vocal cords, actress and singer Julie Andrews lost her singing voice in 1997. That's when she paid a visit to Steven Zeitels, a professor of laryngeal surgery at Harvard Medical School, seeking help. Zeitels had already started working to conceptualize the development of a new type of material that could be implanted into scarred vocal cords to restore their normal function. In 2002, he engaged the help of MIT’s Robert Langer, the David H. Koch Institute Professor in the Department of Chemical Engineering, an expert in developing polymers for bio-medical applications.

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The polymer gel that mimics the vibrations of human vocal cords

The team led by Langer and Zeitels has at present developed a polymer gel that they hope to start examining in a small clinical trial next year. The gel, which mimics key traits of human vocal cords, could help millions of people with voice disorders.  A former MIT researcher who developed the gel while working as a postdoc in the Langer lab, Sandeep Karajanagi says, nearly 6 percent of the US population has some kind of voice disorder, and the majority of those cases involve scarring of the vocal cords. Many of those are children whose cords are scarred from intubation during surgery, while others are victims of laryngeal cancer. People who strain their voices a lot, like teachers, can hugely benefit from this gel. Zeital says, "This would be so valuable to society, because every time a person loses their voice, say, a teacher or a politician, all of their contributions get lost to society, because they can’t communicate their ideas.”

Two different approaches were considered by Langer and team when they joined hands for this research. One involved creating a synthetic material that would mimic the properties of vocal cords, whereas the second involved engineering artificial vocal-cord tissue. Both approaches were possible, Langer says, but the team decided to pursue a synthetic material because it would likely take less time to reach patients. “Making a totally natural vocal cord is a more long-term project,” he says. Some earlier treatments involved treating vocal-fold scars with materials normally used in dermatology or plastic surgery, in hopes of softening the vocal cords, but those don’t work for everyone, and the effects don’t last long, says Nathan Welham, assistant professor of otolaryngology at the University of Wisconsin School of Medicine. Welham, who is not involved in this project says, “Scarred vocal cords are really hard to fix. People have tried this and that, but there’s really no commonly used, available approach that treats the inherent problem of scarring in the vocal folds.”

Former researchers have tried formulating drugs that would dissolve the scar tissue, but the MIT/Harvard team decided to take a different approach. “What we did differently is we looked at this as a mechanical problem that we need to solve. We said, ‘Let’s not look at the scar itself as a problem, let’s think of how we can improve the voice despite the presence of the scar tissue,’” says Karajanagi, who is now an instructor of surgery at Harvard Medical School and a researcher at the Center for Laryngeal Surgery and Voice Rehabilitation at Massachusetts General Hospital.

You may also see how this gel functions: Mimicking vocal cord vibrations - YouTube

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