The vocal folds are pivotal in human communication, functioning as the primary tone generator of the body. This study investigates advancements in the evaluation of vocal fold functionality through voice-related biomarkers with clinically validated methods, such as basic acoustic measures, Maximum Phonation Time (MPT), the Voice Handicap Index (VHI), and the GRBAS scale. They provide structured frameworks for assessing vocal fold states. Research on genetic regulation of fundamental frequency highlights the significance of integrating genomic and biochemical data to understand vocal fold function and development. Despite advancements in the understanding of many tissue components like elastin and fibrinogen, clinical applications for pathologies of the vocal folds such as multi-handicap syndromes and neurodegenerative disorders remain limited. Regular biopsy changes the function of the vocal folds and cannot be carried out in vivo.

Environmental factors, such as radiation exposure, impact vocal folds and are badly understood. Studies on pubertal individuals from Chornobyl revealed reduced pitch range and intensity. Optical Coherence Tomography (OCT) has emerged as an optical biopsy. It is a tool for visualizing tissue and eventual abnormalities, offering significant potential in evaluating hormonal tissue effects, and biochemical properties in defined in vivo situations. Biochemical understanding of medical treatments for tissue-specific abnormalities, such as genetic and hormonal imbalances, are underexplored.

This article underscores the necessity of an interdisciplinary approach to vocal fold understanding, integrating biochemical research with clinical practice, that includes among others OCT and defined voice-related biomarkers. This integration is crucial for addressing gaps in diagnostics and treatment, ultimately improving outcomes in managing e.g. hormonal, genetic, neurodegenerative, and environmentally induced voice disorders.