Campagnolo Andréa M, Tsuji Domingos Hiroshi, Sennes Luiz Ubirajara, Imamura Rui, Saldiva Paulo H N
Department of Otolaryngology, University of São Paulo School of Medicine, São Paulo, Brazil.
Ann Otol Rhinol Laryngol. 2010 Feb;119(2):133-9. doi: 10.1177/000348941011900211.
Injectable corticosteroids have been used in phonosurgery to prevent scarring of the vocal fold because of their effects on wound healing, and to ensure better voice quality. We histologically evaluated the effects of dexamethasone sodium phosphate infiltration on acute vocal fold wound healing in rabbits 3 and 7 days after surgically induced injury by quantification of the inflammatory reaction and collagen deposition.
A standardized surgical incision was made in the vocal folds of 12 rabbits, and 0.1 mL dexamethasone sodium phosphate (4 mg/mL) was injected into the left vocal fold. The right vocal fold was not injected and served as the control. The larynges were collected 3 and 7 days after surgery. For histologic analysis, the vocal folds were stained with hematoxylin-eosin for quantification of the inflammatory response and with picrosirius red for quantification of collagen deposition.
There was no quantitative difference in the inflammatory response between vocal folds injected with the corticosteroid and control vocal folds. However, the rate of collagen deposition was significantly lower in the corticosteroid-treated group at 3 and 7 days after injury (p = 0.002).
The present results suggest that dexamethasone reduces collagen deposition during acute vocal fold wound healing.
注射用皮质类固醇已用于嗓音外科手术,以防止声带瘢痕形成,因为其对伤口愈合有影响,并确保更好的嗓音质量。我们通过量化炎症反应和胶原蛋白沉积,对手术诱导损伤后3天和7天的兔急性声带伤口愈合中磷酸地塞米松浸润的效果进行了组织学评估。
在12只兔的声带处做标准化手术切口,向左侧声带注射0.1 mL磷酸地塞米松(4 mg/mL)。右侧声带不注射作为对照。术后3天和7天收集喉部。用于组织学分析时,声带用苏木精-伊红染色以量化炎症反应,用天狼星红染色以量化胶原蛋白沉积。
注射皮质类固醇的声带与对照声带之间的炎症反应在数量上没有差异。然而,在损伤后3天和7天,皮质类固醇治疗组的胶原蛋白沉积率显著较低(p = 0.002)。
目前的结果表明,地塞米松可减少急性声带伤口愈合过程中的胶原蛋白沉积。