Olmos-Zuñiga J Raúl, Dorantes-Mancebo del Castillo Ignacio, Avila-Chávez Arturo, Jasso-Victoria Rogelio, Gaxiola-Gaxiola Miguel, Sotres-Vega Avelina, Hernández-Jiménez Claudia, Ramírez-García Arturo, Santillan-Doherty Patricio
Departamento de Cirugía Experimental, Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas, México, D.F.
Acta Otorrinolaringol Esp. 2013 Jan-Feb;64(1):37-44. doi: 10.1016/j.otorri.2012.06.010. Epub 2012 Oct 11.
Glutaraldehyde-preserved bovine pericardium (GBP) and lyophilized GBP (LGBP) have been used successfully in repairing several anatomical defects, but their effectiveness and safety as implants to vocal cords (VC) have not been reported.
The aim of this study was to evaluate the use of GBP and LGBP as materials for medialization thyroplasty, as well as to assess the endoscopic, macroscopic and microscopic VC changes after medialization in an experimental canine model.
In 12 healthy mongrel dogs, the right VC were medialized using pericardium and the left with polytetrafluoroethylene (PTFE). Group 1 (n=6): GBP and Group 2 (n=6): LGBP. The surgical manoeuvrability of the implants was compared. The animals were evaluated clinically and endoscopically. Three months after surgery, the larynges were assessed macro- and microscopically.
Both GBP and LGBP implants showed better surgical manoeuvrability (Kruskal-Wallis, P=.005). Endoscopic and macroscopic studies showed no evidence of granulomas, absorption or extrusion of the implant. At the end of the study, greater thickness was observed in VC implanted with PTFE. Microscopically, all the VC developed fibrous capsules surrounding the implants and similar chronic inflammation reaction. The VC implanted with PTFE presented eosinophilic infiltration (Kruskal-Wallis, P<.05).
Both GBP and LGBP can be used as implants for VC medialization because they are biocompatible, have easy surgical manoeuvrability, do not suffer absorption, migration or extrusion and produce inflammation reactions similar to those of PTFE.
戊二醛保存的牛心包（GBP）和冻干GBP（LGBP）已成功用于修复多种解剖缺陷，但它们作为声带（VC）植入物的有效性和安全性尚未见报道。
本研究旨在评估GBP和LGBP作为喉内移植物材料的应用，并在实验犬模型中评估喉内移植物术后内镜、大体和显微镜下VC的变化。
选取12只健康杂种犬，右侧VC使用心包进行喉内移植物手术，左侧使用聚四氟乙烯（PTFE）。第1组（n = 6）：GBP；第2组（n = 6）：LGBP。比较植入物的手术操作性。对动物进行临床和内镜评估。术后3个月，对喉部进行大体和显微镜评估。
GBP和LGBP植入物均显示出更好的手术操作性（Kruskal-Wallis检验，P = 0.005）。内镜和大体研究未发现植入物有肉芽肿、吸收或挤出的迹象。在研究结束时，观察到植入PTFE的VC厚度更大。显微镜下，所有VC均在植入物周围形成纤维囊并出现类似的慢性炎症反应。植入PTFE的VC出现嗜酸性粒细胞浸润（Kruskal-Wallis检验，P < 0.05）。
GBP和LGBP均可作为VC喉内移植物使用，因为它们具有生物相容性，手术操作性良好，不会发生吸收、迁移或挤出，并且产生与PTFE类似的炎症反应。
