Associations Between Immunological Biomarkers, Voice Use Patterns, and Phonotraumatic Vocal Fold Lesions: A Scoping Review

Abstract

ObjectivesThis review aims to explore potential associations between immunological biomarkers and phonotraumatic vocal fold lesions. Study designScoping review. MethodsOvidMEDLINE, CINAHL, PubMed, Proquest Theses and Dissertations, Scopus and Web of Science were searched using the terms “vocal fold” and “inflammatory marker” initially, and later “development” and “phonotraumatic lesion”. Papers were included for review if they were published in the last 20 years in English language, used human cell lines or biological samples, and outcomes were measured objectively using immunological biomarkers. Results4,107 papers were identified for screening. 1,257 duplicates were removed by automation tools EndNote and Covidence. A further 2,687 papers were excluded by reviewers at the title and abstract screening stage. 62 papers underwent full-text screening and 28 publications were ultimately included in the review. ConclusionsResearch concerning the possible association between immunological biomarkers and phonotraumatic lesions is still in its early stages, largely due to difficulty obtaining biological vocal fold samples in a safe and non-invasive manner, and challenges in identifying laboratory techniques that are sensitive enough to detect concentrations of biomarkers in small volumes of vocal fold samples. Signalling molecules are likely the most promising biomarkers to investigate the role of voice use patterns in the development of phonotraumatic lesions due to relatively rapid shifts in response to host conditions. Future research would benefit from control of potential systemic contributions to laryngeal manifestations of inflammation.