Tulleners E, Mann P, Raker C W
Department of Clinical Studies, University of Pennsylvania, School of Veterinary Medicine, Kennett Square.
Vet Surg. 1990 May-Jun;19(3):181-90. doi: 10.1111/j.1532-950x.1990.tb01164.x.
Epiglottic augmentation with injectable bovine collagen or an autogenous or allogenous auricular cartilage graft was performed in 12 horses with endoscopically and radiographically normal epiglottises. The grafting procedures were easy to perform and did not cause apparent discomfort. Cartilage graft extrusion or resorption may have occurred, but was not seen by endoscopy and lateral laryngeal radiography. Only collagen implants remained evident endoscopically, as smooth round submucosal bulges ventral to the epiglottic cartilage. Two horses with collagen implants, and all horses with cartilage autografts and allografts, were euthanatized at week 16. One horse with a collagen implant was euthanatized at week 4 and one at week 6. The epiglottis appeared thickened in three horses with collagen implants, two horses with autogenous grafts, and three horses with allogenous grafts. Pharyngeal lymphoid tissue was hyperplastic in two horses with autografts and three horses with allografts, but not in horses with collagen implants. Collagen grafts persisted as one or two smooth bulges 8 mm in diameter. Collagen incited a brisk foreign body reaction that was surrounded by a fibrous connective tissue capsule. Epiglottises of the horses with collagen implants were significantly thicker 20 mm from the tip than those of normal horses and horses with allografts. Cartilage graft incorporation was not evident grossly and was seen on microscopic examination in only one autograft. Thickening was caused by submucosal fibrosis.
对12匹会厌在内镜检查和放射检查中均正常的马进行了会厌增大术，采用可注射牛胶原蛋白或自体或异体耳廓软骨移植。移植手术操作简便，未引起明显不适。软骨移植可能发生了挤出或吸收，但在内镜检查和喉侧位X线片上未观察到。在内镜下，仅胶原蛋白植入物仍明显可见，表现为会厌软骨腹侧光滑的圆形黏膜下隆起。2匹植入胶原蛋白的马，以及所有接受自体软骨移植和异体软骨移植的马，在第16周时实施了安乐死。1匹植入胶原蛋白的马在第4周实施了安乐死，1匹在第6周实施了安乐死。3匹植入胶原蛋白的马、2匹接受自体移植的马和3匹接受异体移植的马的会厌出现增厚。2匹接受自体移植的马和3匹接受异体移植的马的咽淋巴组织增生，但植入胶原蛋白的马未出现这种情况。胶原蛋白移植物以一个或两个直径8毫米的光滑隆起持续存在。胶原蛋白引发了强烈的异物反应，周围有纤维结缔组织包膜。植入胶原蛋白的马的会厌在距尖端20毫米处明显比正常马和接受异体移植的马的会厌厚。软骨移植的融合在大体上不明显，仅在一个自体移植中通过显微镜检查可见。增厚是由黏膜下纤维化引起的。
