Hanauer Aline D, Fraga Jose Carlos, Sousa Joao K, Sanches Paulo R, Duarte Marcos E, Ulbrich-Kulczynski Jane, Filho Orlando H, Saueressig Mauricio G
Pediatric Surgery, Hospital de Clínicas, School of Medicine, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos 2500, sala 600, Porto Alegre, Rio Grande do Sul, 90000-000, Brazil.
Pediatr Surg Int. 2007 Dec;23(12):1227-31. doi: 10.1007/s00383-007-2017-4. Epub 2007 Sep 26.
Subglottic stenosis (SGS) is defined as the narrowing of the lower larynx. Difficulties in the management of subglottic stenosis, especially in the pediatric population, justify the development of experimental models. The objective of this study was to compare the two methods of experimental subglottic stenosis induction. Twenty-three dogs were randomly selected and assigned by lottery to either one of the two groups: Gp I (n = 10) of electrocoagulation; and Gp II (n = 13) of 23% NaOH injection. In Gp I, self-interruption electrocoagulation was applied to one point in each of the four quadrants of the cricoid cartilage. In Gp II, 0.2 ml of 23% NaOH was injected in the submucosal layer in the anterior and posterior portions of the cricoid cartilage. Once a week, endoscopy was performed and the caliber of the subglottic region was measured using endotracheal tubes, and the injection was repeated if there were no signs of subglottic stenosis. The animals were killed on day 21; animals that developed respiratory distress were killed before day 21. One animal in Gp I died on day 14 after the injection and during transportation; two animals in Gp II died, one on day 7 due to a tracheoesophageal fistula, and the other of unknown causes on day 5. Significant subglottic stenosis (over 51% obstruction) was found in 67% of the animals in Gp I and in 64% of those in Gp II (P = 0.99). Median time to development of significant stenosis was 21 days in both groups, and required either two or three injections. Mean time for the performance of the procedures was significantly shorter (P < 0.01) in Gp I (mean: 6.36 min) than in Gp II (mean: 14.88 min). Electrocoagulation and 23% NaOH injection in the subglottic region were effective in the development of significant subglottic stenosis in dogs, both methods leading to stenosis in the same period of time and after the same number of procedures. However, electrocoagulation was the fastest method.
声门下狭窄（SGS）被定义为下喉部的狭窄。声门下狭窄的治疗存在困难，尤其是在儿科人群中，这使得实验模型的开发具有合理性。本研究的目的是比较两种诱导实验性声门下狭窄的方法。随机选择23只犬，通过抽签将其分配到两组中的一组：第一组（Gp I，n = 10）采用电凝法；第二组（Gp II，n = 13）采用23%氢氧化钠注射法。在第一组中，对环状软骨四个象限中的每个象限的一个点进行自中断电凝。在第二组中，将0.2 ml 23%的氢氧化钠注射到环状软骨前后部的黏膜下层。每周进行一次内镜检查，使用气管导管测量声门下区域的管径，如果没有声门下狭窄的迹象，则重复注射。在第21天处死动物；出现呼吸窘迫的动物在第21天之前处死。第一组中有1只动物在注射后第14天运输过程中死亡；第二组中有2只动物死亡，1只在第7天因气管食管瘘死亡，另1只在第5天死因不明。第一组67%的动物和第二组64%的动物出现了显著的声门下狭窄（梗阻超过51%）（P = 0.99）。两组出现显著狭窄的中位时间均为21天，且需要进行两到三次注射。第一组手术操作的平均时间（平均：6.36分钟）明显短于第二组（平均：14.88分钟）（P < 0.01）。声门下区域的电凝和23%氢氧化钠注射在犬身上有效诱导出显著的声门下狭窄，两种方法在相同时间和相同次数的操作后导致狭窄。然而，电凝法是最快的方法。
