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Branco et al

as well as a decrease of elastic fibers. The concentration of collagens IV and V did not change according to age group. These findings suggest that as men age, the density of the extracellular matrix increases, brought about by an increase in collagen, while the loss of elastin results in decreased viscoelasticity. Author Contributions Anete Branco , interpretation of data for the work, drafting the work, final approval of the work, agreement to be accountable for all aspects of the work; Alexandre Todorovic Fabro , interpreta- tion of data for the work, drafting the work, final approval of the work, agreement to be accountable for all aspects of the work, data analysis; Tatiana Maria Gonc x alves , interpretation of data for the work, drafting the work, final approval of the work, agreement to be accountable for all aspects of the work; Regina Helena Garcia Martins , study design, interpretation of the data, writing and approval of the manuscript, critical revision, final approval, agree- ment to be accountable for all aspects of the work. Disclosures Competing interests: None. Sponsorships: Fapesp and Fundunesp, financial support to immu- nohistochemical analysis and English version. Funding source: None 1. Butler JE, Hammond TH, Gray SD. Gender-related differences of hyaluronic acid distribution in the human vocal fold. Laryngoscope . 2001;111:907-911. 2. Ramos HV, Simo˜es MJ, Pontes PA, et al. Immunohistochemistry as a method to study elastic fibers of human vocal fold. Braz J Otorhinolaryngol . 2005;71:486-491. 3. Ishii K, Yamashita K, Akita M, Hirose H. Age-related devel- opment of the arrangement of connective tissue fibers in the lamina propria of the human vocal fold. Ann Otol Rhinol Laryngol . 2000;109:1055-1064. 4. Hammond T, Gray S, Butler J. Age and gender related col- lagen distributions in human vocal folds. Ann Otol Rhinol Laryngol . 2000;109:913-920. 5. Sato K, Hirano M, Nakashima T. Age-related changes of col- lagenous. Ann Otol Rhinol Laryngol . 2002;111:15-20. 6. Gray SD, Titze IR, Alipour F, Hammond TH. Biomechanical and histologic observations of vocal fold fibrous proteins. Ann Otol Rhinol Laryngol . 2000;109:77-85. 7. Kutty JK, Webb K. Tissue engineering therapies for the vocal fold lamina propria. Tissue Eng Part B Rev . 2009;15:249-262. 8. Hirano M. Morphological structure of the vocal cord as a vibrator and its variations. Folia Phoniatr . 1974;26:89-94. 9. Hirano M, Kurita S, Nakashima T. Growth, development and aging of human vocal folds. In: Bless DM, Abbs JH, eds. Vocal Fold Physiology . San Diego, CA: College-Hill; 1983:22-43. 10. Sato K, Hirano M, Nakashima T. Fine structure of the human newborn and infant vocal fold mucosae. Ann Otol Rhinol Laryngol . 2001;110:417-424. 11. Gray SD. Cellular physiology of the vocal folds. Otolaryngol Clin North Am . 2000;33:679-697.12 References

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