Kruschewsky Leonardo de Souza, de Mello-Filho Francisco Verissimo, dos Santos Antonio Carlos, Rosen Clark Alan
Department of Ophthalmology, Otolaryngology and Head and Neck Surgery, Physical Medicine and Image Science Center, University Hospital, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.
Laryngoscope. 2007 Jan;117(1):96-100. doi: 10.1097/01.mlg.0000245013.98844.30.
The objective of this experimental prospective study on an animal model was to determine the rate of autologous fat graft absorption in 24 paralyzed canine left vocal folds 12 weeks after introduction.
Forty mongrel dogs of both sexes weighing 15 to 20 kg were divided into three study groups (SGs) of eight dogs each whose larynges were grafted by vocal fold lipoinjection (VFL-SGA), vocal fold lipoinjection plus insulin (VFLi-SGB), and by fat graft medialization laryngoplasty (FGML-SGC) and observed for 12 weeks. Two control groups (CGs) of eight dogs each were submitted to fat graft medialization laryngoplasty (FGML-CG1) and by vocal fold lipoinjection (VFL-CG2), respectively, followed by immediate killing. All 40 dogs were submitted to left vagal and recurrent laryngeal nerve resection. All animals were confirmed to have a left vocal fold paralysis 4 weeks later when 2 mL of autologous fat graft was placed inside the left paraglottic space. The larynges were removed at preestablished times and studied for remaining fat graft volume by magnetic resonance imaging.
The mean volume obtained by imaging were 1.9388 mL for CG1, 1.0476 mL for CG2, 0.1924 mL for VFL, 0.336 mL for VFLi, and 0.565 mL for FGML. CG1 and CG2 did not differ significantly from one another but differed from the SGs, with statistical analysis suggesting a lower absorption of the fat graft in FGML.
The absorption rate was 82% in SGA, 68% in the SGB, and 71% in SGC.
本动物模型实验前瞻性研究的目的是确定24只瘫痪犬左侧声带在注入自体脂肪12周后的吸收速率。
将40只体重15至20千克的雌雄杂种犬分为三个研究组(SG),每组8只,分别通过声带脂肪注射(VFL-SGA)、声带脂肪注射加胰岛素(VFLi-SGB)和脂肪移植喉内移术(FGML-SGC)对喉部进行移植,并观察12周。两个对照组(CG)每组8只犬,分别接受脂肪移植喉内移术(FGML-CG1)和声带脂肪注射(VFL-CG2),随后立即处死。所有40只犬均接受左侧迷走神经和喉返神经切除术。4周后确认所有动物左侧声带麻痹,此时将2毫升自体脂肪移植到左侧声门旁间隙。在预定时间切除喉部,通过磁共振成像研究剩余脂肪移植体积。
CG1成像获得的平均体积为1.9388毫升,CG2为1.0476毫升,VFL为0.1924毫升,VFLi为0.336毫升,FGML为0.565毫升。CG1和CG2之间差异不显著,但与SG组不同,统计分析表明FGML中脂肪移植的吸收较低。
SGA的吸收率为82%,SGB为68%,SGC为71%。