Hwang Peter H, Chan Joe M
Department of Otolaryngology-Head and Neck Surgery, Stanford University, Stanford, California 94305, USA.
Laryngoscope. 2006 Jul;116(7):1080-5. doi: 10.1097/01.mlg.0000224352.50256.99.
OBJECTIVES/HYPOTHESIS: Retinoids have been shown to be important cofactors in regulating the differentiation and proliferation of ciliated epithelial cells of the respiratory tract. In particular, retinoic acid has been shown to enhance the regeneration of paranasal sinus mucosa. The objective of this study is to use scanning electron microscopy techniques to evaluate the effect of topical retinoic acid on mucosal wound healing in a rabbit model of maxillary sinus surgery. It is hypothesized that the application of topical retinoic acid will enhance ciliogenesis and improve the morphology of regenerated cilia compared with controls.
Prospective multi-arm controlled animal trial.
Eighteen New Zealand white rabbits underwent surgical opening of the maxillary sinuses through a midline incision. The rabbits were divided among four experimental groups: 1) mucosal stripping alone (stripped control), 2) stripping followed by topical application of an inert aqueous gel, 3) stripping followed by application of 0.01% retinoic acid in aqueous gel, and 4) no mucosal stripping and no topical treatment (nonstripped control). After 14 days, the medial wall of the maxillary sinus was harvested and examined by scanning electron microscopy at x2,000 and x5,000 magnification. The micrographs were then rated by a blinded review panel for ciliary density, orientation, and morphology.
Mean scores for ciliary density, orientation, and morphology were all significantly higher for the retinoic acid treatment group compared with both the inert aqueous gel treatment group and the stripped control group (P=.004-.03 for all comparisons, Student's t test). Mean scores for the retinoic acid treatment group were numerically lower than the nonstripped control group but did not approach statistical significance for any parameter (P=.23-.31).
In a rabbit model of maxillary sinus surgery, topically delivered retinoic acid enhances ciliogenesis. Qualitative assessment of ciliary density, orientation, and morphology shows improved healing in retinoic acid treated sinuses compared with both untreated control sinuses and aqueous gel treated sinuses.
目的/假设：类视黄醇已被证明是调节呼吸道纤毛上皮细胞分化和增殖的重要辅助因子。特别是，维甲酸已被证明可促进鼻窦黏膜的再生。本研究的目的是使用扫描电子显微镜技术评估局部应用维甲酸对兔上颌窦手术黏膜伤口愈合的影响。假设与对照组相比，局部应用维甲酸将增强纤毛生成并改善再生纤毛的形态。
前瞻性多组对照动物试验。
18只新西兰白兔通过中线切口进行上颌窦手术切开。将兔子分为四个实验组：1）仅黏膜剥离（剥离对照组），2）剥离后局部应用惰性水凝胶，3）剥离后应用含0.01%维甲酸的水凝胶，4）不进行黏膜剥离且不进行局部治疗（未剥离对照组）。14天后，采集上颌窦内侧壁，用扫描电子显微镜在2000倍和5000倍放大倍数下进行检查。然后由一个盲法评审小组对显微照片的纤毛密度、方向和形态进行评分。
与惰性水凝胶治疗组和剥离对照组相比，维甲酸治疗组的纤毛密度、方向和形态的平均评分均显著更高（所有比较的P值为0.004 - 0.03，采用学生t检验）。维甲酸治疗组的平均评分在数值上低于未剥离对照组，但在任何参数上均未达到统计学显著性（P值为0.23 - 0.31）。
在兔上颌窦手术模型中，局部递送的维甲酸可增强纤毛生成。对纤毛密度、方向和形态的定性评估显示，与未治疗的对照鼻窦和水凝胶治疗的鼻窦相比，维甲酸治疗的鼻窦愈合情况有所改善。
