Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University School of Medicine, Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea.
J Voice. 2012 Jul;26(4):515-20. doi: 10.1016/j.jvoice.2011.07.004. Epub 2011 Oct 28.
To determine whether detergent treated allogenic cartilage can be used as a substitute for autologous cartilage in a canine paralyzed vocal fold model.
Twelve canines underwent a right recurrent laryngeal nerve resection with injections of allogenic auricular cartilage (harvested 7 days prior, treated with detergent, and minced), with a hyaluronic acid hydrogel (0.2 mL) into the right thyroarytenoid muscle, and with a pressure syringe under direct laryngoscopy. Two animals were sacrificed and larynges removed at each time point: 1-, 3-, 6-, 12-, 18-, and 24-months post injection. Hematoxylin-eosin and immunohistochemistry for expression of major histocompatibility complex-II (MHC-II) antigen was measured to assess histomorphology and gross volume and loss of antigenicity of the injected allogenic cartilage.
Injected allogenic cartilage maintained its position and volume in the vocalis muscle throughout 24 months. Cartilage was characterized with empty lacunae indicating possible loss of viability. Fibrotic changes were noted in the surrounding cartilage. MCH-II antigen was not identified in the perichondrium and/or cartilage. Inflammatory reaction, granuloma, or foreign body reaction was not observed at any time point.
These preliminary results suggest that allogenic auricular cartilage grafts treated with detergent are well tolerated and may be an effective material for volumetric augmentation in the paralyzed vocal fold.
确定经去污剂处理的同种异体软骨能否在犬麻痹性声带模型中替代自体软骨。
12 只犬接受右侧喉返神经切除术,同时向右侧杓状软骨肌内注射同种异体耳廓软骨(7 天前采集,经去污剂处理后切碎)和透明质酸水凝胶(0.2ml),并在直接喉镜下使用压力注射器。每只动物在以下时间点处死并取出喉部:注射后 1、3、6、12、18 和 24 个月。采用苏木精-伊红染色和主要组织相容性复合体-II(MHC-II)抗原免疫组化检测,评估注射的同种异体软骨的组织形态学、大体体积和抗原性丧失情况。
注射的同种异体软骨在 24 个月内始终保持在声带肌内的位置和体积。软骨有空腔,表明可能失去了活力。周围软骨有纤维化改变。软骨膜和/或软骨中未检测到 MHC-II 抗原。在任何时间点均未观察到炎症反应、肉芽肿或异物反应。
这些初步结果表明,经去污剂处理的同种异体耳廓软骨移植物具有良好的耐受性,可能是麻痹性声带体积增大的有效材料。