Controlled electron microscopy of the epithelium in voice lesions revealed: thickening and destruction of basement membrane, reduplication of the lamina densa, near absence of normal hemidesmosomes and anchoring fibrils, abundant electro-dense vesicles at the basal cell pole (discharging through the cell membrane), abundant mitochondria, euchromatin and nucleolar prominence. These histologic phenomena suggest that the basal cell layer responds to trauma to its anchorages with metabolic hyperactivity. Therefore the traumatic mechanism should be considered as damaging to the basement membrane.