• Author
    Keer Zhang
  • Discovery PI

    Jennifer Long MD PhD

  • Project Co-Author

    Georgia Crane, Mateo Ruiz Alvarez, Michael Döllinger

  • Abstract Title

    Vocal Outcomes After Cell-Based Outer Vocal Fold Implant in Porcine Bilateral Vocal Fold Resection

  • Discovery AOC Petal or Dual Degree Program

    Basic, Clinical, & Translational Research

  • Abstract

    OBJECTIVE
    Cell-based outer vocal fold replacement (COVR) offers potential treatment for severe vocal fold scarring or cancer reconstruction. COVR consists of multipotent human adipose-derived stem cells embedded within a three-dimensional fibrin scaffold that replicates native vocal fold layers. Prior rabbit studies demonstrated enhanced wound healing, subsequent safety and toxicity studies confirmed COVR’s safety in pigs. Building on prior work defining pig-specific acoustic parameters, this study evaluates phonatory recovery following bilateral cordectomy and COVR implantation and establishes a framework for quantitative voice assessment in a large animal model.

    METHODS
    COVR implantation was performed in eight Yucatan mini-pigs after bilateral vocal fold resection. Functional voice recovery was tracked, with spontaneous vocalizations recorded pre- and post-surgery for up to six months. Pig squeals were extracted using Python, manually verified, and nonrepresentative sounds excluded. Acoustic features including Q50 (median frequency of spectral energy), flux (rate of spectral energy change), F0 (fundamental frequency), jitter (period perturbation), and shimmer (amplitude perturbation) were analyzed using linear mixed-effect models and Wilcoxon rank sum test with Benjamini-Yekutieli correction.

    RESULTS
    Q50 significantly decreased immediately postoperatively (p=.001) and returned to preoperative range by six months, while F0 (p<.001) and flux (p=.004) increased over time. Following bilateral cordectomy, COVR implantation altered voice outcomes and enhanced acoustic performance.

    CONCLUSIONS

    COVR implantation improved key nonperiodic acoustic parameters after extensive laryngeal injury. Future work includes one-year monitoring to assess long-term voice recovery and extracellular matrix remodeling, artificial intelligence integration for expanded acoustic analysis, and a unilateral injury model comparing control cordectomy alone versus COVR reconstruction.

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