Pitman Michael J, Cabin Jonathan A, Iacob Codrin E
Otolaryngology- HNS, The Voice and Swallowing Institute, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, USA
Otolaryngology-Head & Neck Surgery, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, USA.
Ann Otol Rhinol Laryngol. 2016 Feb;125(2):137-44. doi: 10.1177/0003489415601685. Epub 2015 Sep 13.
Evaluate the histologic effects of grafting porcine-derived small intestinal submucosa (SIS) into the vocal fold superficial lamina propria (SLP) layer for the potential treatment of vocal fold scar, sulcus and superficial lamina propria atrophy.
Small intestinal submucosa was implanted into the right vocal fold SLP of 6 mongrel dogs. The left vocal fold served as a sham surgical control. At 2, 4, and 6 weeks postoperative, bilateral vocal fold specimens were evaluated histologically.
At 2 and 4 weeks, respectively, SIS-implanted vocal folds demonstrated moderate and mild inflammation and acute and chronic inflammation. At 6 weeks, inflammation was minimal and chronic. The 6-week specimens showed copious amounts of newly generated hyaluronic acid (HA) within the graft. There was no reactive fibrosis at 6 weeks.
In the canine model, SIS appears safe for SLP grafting. Inflammation is similar to that of sham surgery. Small intestinal submucosa results in newly generated HA without concomitant fibrosis. Small intestinal submucosa has potential to be used in treatment of disorders with SLP, including vocal fold scar, sulcus, and atrophy. Studies evaluating the effect of SIS implantation on vocal fold function, as well as the ultimate fate of the graft, are required.
评估将猪源小肠黏膜下层（SIS）移植到声带固有层浅层（SLP）对声带瘢痕、沟及固有层浅层萎缩的潜在治疗效果。
将小肠黏膜下层植入6只杂种犬的右侧声带SLP。左侧声带作为假手术对照。术后2周、4周和6周，对双侧声带标本进行组织学评估。
分别在术后2周和4周，植入SIS的声带表现为中度和轻度炎症，以及急性和慢性炎症。在6周时，炎症轻微且为慢性。6周时的标本显示移植物内有大量新生成的透明质酸（HA）。6周时无反应性纤维化。
在犬模型中，SIS似乎对SLP移植是安全的。炎症与假手术相似。小肠黏膜下层可产生新生成的HA且无伴随纤维化。小肠黏膜下层有潜力用于治疗SLP相关疾病，包括声带瘢痕、沟及萎缩。需要开展评估SIS植入对声带功能影响以及移植物最终转归的研究。
