Garrett C G, Soto J, Riddick J, Billante C R, Reinisch L
Department of Otolaryngology, Vanderbilt Bill Wilkerson Center for Otolaryngology and Communication Sciences, Nashville, Tennessee, USA.
Ann Otol Rhinol Laryngol. 2001 Jan;110(1):25-30. doi: 10.1177/000348940111000105.
For evaluation of the effect of topical mitomycin-C on vocal fold healing and return of function after surgical excision of mucosa, 6 dogs underwent suspension microlaryngoscopy with bilateral microflap excision of vocal fold mucosa. Topical mitomycin-C, a chemotherapeutic agent and a fibroblast inhibitor, was applied randomly to one side, with the contralateral side serving as the control. Laryngeal videostroboscopy (LVS) was performed on each animal before the operation, at 2 weeks, and before sacrifice at 4 weeks. Both functional analysis with LVS and histologic analysis were performed in a blinded fashion to determine the effect of mitomycin-C on healing. Histologic analysis was augmented with computer morphometrics. The LVS revealed diminished mucosal wave vibration in the vocal folds treated with mitomycin-C, as well as a more atrophic appearance to the vibratory surface. The vocal folds treated with mitomycin-C showed fewer fibroblasts and less collagen within the superficial layer of the lamina propria than the control vocal folds (p < .05, Student's t-test, paired analysis). Inflammatory infiltrate was not significantly different between the two sides. Consistent with the known suppression of fibroblast proliferation by mitomycin-C, the treated vocal folds showed less connective tissue response to the surgical injury. In contrast to the reported positive effects of mitomycin-C on tracheal and glottic stenosis, the observed decrease in the healing response in the present study had negative consequences on the vocal fold vibratory pattern.
为评估局部应用丝裂霉素-C对声带黏膜手术切除后愈合及功能恢复的影响，6只犬接受了双侧声带黏膜微型瓣切除的悬吊式显微喉镜检查。化疗药物及成纤维细胞抑制剂丝裂霉素-C随机应用于一侧，对侧作为对照。在术前、术后2周及4周处死前对每只动物进行喉动态镜检查（LVS）。采用盲法进行LVS功能分析及组织学分析，以确定丝裂霉素-C对愈合的影响。组织学分析采用计算机形态测量法增强。LVS显示，丝裂霉素-C处理的声带黏膜波振动减弱，振动表面萎缩更明显。与对照声带相比，丝裂霉素-C处理的声带固有层浅层成纤维细胞数量更少，胶原含量更低（p < 0.05，学生t检验，配对分析）。两侧的炎性浸润无显著差异。与丝裂霉素-C对成纤维细胞增殖的已知抑制作用一致，处理后的声带对手术损伤的结缔组织反应更小。与丝裂霉素-C对气管和声门狭窄的报道积极作用相反，本研究中观察到的愈合反应降低对声带振动模式产生了负面影响。
