Novakovic Daniel, D'Elia Joanna, Branski Ryan C, Blitzer Andrew
Ann Otol Rhinol Laryngol. 2014 Jun;123(6):387-94. doi: 10.1177/0003489414526688.
Vocal fold hematoma is traditionally managed with a period of voice rest, in the order of weeks, to allow natural resolution. This study is designed to examine the efficacy and safety of a number of hemoglobin-avid (vascular) lasers when used in the setting of acute vocal fold hematoma.
Venous blood drawn from 4 white rabbits was used to create an array of subepithelial hematomas in the buccal cavities of each animal. Laser energy from I of 3 different lasers (532-nm pulsed potassium titanyl phosphate [KTP], 532-nm diode KTP, and 940-nm diode laser) was applied to each of the test hematomas at varying energy levels. Hematoma sites were photographed at days 0, 1, 5, 7, 9, and 12. Two animals were sacrificed on day 7 and the remainder on day 12. Histological evaluation of collateral tissue damage and residual hematoma was performed on biopsy specimens.
Macroscopic and microscopic ulceration at laser-treated sites was mostly resolved by day 7. Inflammatory cell infiltrate was present in laser-treated and hematoma-only sites. Laser-treated samples showed alterations in vascularity.
Hemoglobin-avid lasers may be beneficial in accelerating subepithelial hematoma resolution with a favorable tissue damage profile.
传统上,声带血肿的治疗方法是让患者禁声数周,以使血肿自然消退。本研究旨在检验多种血红蛋白亲和性(血管性)激光在急性声带血肿治疗中的有效性和安全性。
从4只白兔采集静脉血,在每只动物的颊腔内制造一系列上皮下血肿。使用3种不同激光(532纳米脉冲钛宝石磷酸钾[KTP]、532纳米二极管KTP和940纳米二极管激光)中的1种,以不同能量水平照射每个测试血肿。在第0、1、5、7、9和12天拍摄血肿部位的照片。在第7天处死2只动物,其余动物在第12天处死。对活检标本进行侧支组织损伤和残余血肿的组织学评估。
激光治疗部位的宏观和微观溃疡在第7天时大多消退。激光治疗部位和仅存在血肿的部位均有炎性细胞浸润。激光治疗的样本显示血管分布有变化。
血红蛋白亲和性激光可能有助于加速上皮下血肿的消退,且组织损伤情况良好。