Correa A J, Reinisch L, Sanders D L, Huang S, Deriso W, Duncavage J A, Garrett C G
Department of Otolaryngology, Vanderbilt Bill Wilkerson Center for Otolaryngology and Communication Sciences, Nashville, Tennessee, USA.
Ann Otol Rhinol Laryngol. 1999 Nov;108(11 Pt 1):1053-60. doi: 10.1177/000348949910801106.
The objective of this randomized, prospective study was to study the efficacy of topical mitomycin-C in the inhibition of subglottic stenosis in a canine model. Subglottic stenosis was elicited with the carbon dioxide laser in 10 mongrel dogs. Radial incision and serial dilation of the subglottic airway were then carried out. The animals were randomized to receive a topical solution of 1% mitomycin-C to the dilated area for a 5-minute duration or no further treatment. Weekly direct microlaryngoscopy and photodocumentation were performed during the 6-week study. Airway distress developed in 4 of the 5 control dogs, requiring early sacrifice, while all treatment group animals survived the duration of the study (p < or = .006). Morphometric analysis of the subglottic photographs confirmed a greater than 100% increase in the percentage of relative airway at sacrifice in the treatment group (p < or = .049). A statistically significant (p < or = .015) decrease in collagen formation in the subglottic scar of dogs treated with topical mitomycin-C was documented. Mitomycin-C favorably altered the clinical progression of subglottic stenosis, improved quantified airway patency, and reduced the amount of subglottic collagen formation in the canine model.
这项随机前瞻性研究的目的是在犬类模型中研究局部应用丝裂霉素-C对声门下狭窄的抑制效果。使用二氧化碳激光在10只杂种犬中诱发声门下狭窄。然后对声门下气道进行放射状切开和连续扩张。将动物随机分为两组,一组在扩张区域局部应用1%丝裂霉素-C溶液5分钟,另一组不进行进一步治疗。在为期6周的研究中,每周进行直接显微喉镜检查并拍照记录。5只对照犬中有4只出现气道窘迫,需要提前处死,而所有治疗组动物均存活至研究结束(p≤0.006)。对声门下照片进行形态计量分析证实,治疗组处死时相对气道百分比增加超过100%(p≤0.049)。记录显示,局部应用丝裂霉素-C治疗的犬声门下瘢痕中胶原形成有统计学意义的减少(p≤0.015)。在犬类模型中,丝裂霉素-C有利地改变了声门下狭窄的临床进展,改善了气道通畅的量化指标,并减少了声门下胶原形成的量。