Objective: We aimed to examine the influence of hyaluronic acid (HA) and basement membrane (BM) thickness alterations on biochemical properties of vocal fold lesions including vocal fold polyps, sulcus vocalis lesions, vocal fold cysts, and Reinke’s edema.

Methods: Archival material of 56 laryngoscopic vocal fold biopsies from 49 patients reported between July 1, 2005 and February 27, 2007 were retrospectively evaluated. Hematoxylin-eosin, alcian blue pH 2.5, and Periodic acid–Schiff (PAS) stainings were histochemically performed.

Results: We detected that the HA component in the extracellular matrix and BM thickness had in-creased in vocal fold polyps, sulcus vocalis lesions, vocal fold cysts, and Reinke’s edema compared with those in the control group.

Conclusion: We believe that HA plays an important role in determining the biochemical properties of vocal fold lesions including vocal fold polyps, sulcus vocalis lesions, vocal fold cysts, and Reinke’s edema. Especially the increase in the HA component in all these lesions indicates that it plays a role in reparative processes.