Kwon Seong Keun, Ryu Yoon-Jong, Kim Dong Wook, Chang Hyun, Kim Soo Yeon, Sung Myung Whun, Hah J Hun
Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, Republic of Korea.
Laryngoscope. 2016 Oct;126(10):2320-4. doi: 10.1002/lary.26089. Epub 2016 Jun 16.
OBJECTIVES/HYPOTHESIS: Validating an antiadhesive strategy to prevent anterior glottic web (AGW) development.
Prospective animal study in rabbits.
Fifteen New Zealand white rabbits were randomly divided into three equal groups (five rabbits each), applying either HyFence (HF: 0.1 g/vocal fold), an antiadhesive test agent; mitomycin-C (MMC: 1 mg/ml, 4 min) as reference therapy; or saline (control group) to AGWs induced by laryngofissure technique (previously reported by us). At week 8, the extent of AGW was measured to assess preventive effects of HF and MMC, and laryngeal specimens were sampled for high-speed recording and histologic analysis.
AGW induction was successful in all five (100%) control rabbits, each demonstrating fibroconnective tissue and collagen fibers at anterior commissure, with AGW ratio averaging 0.57 ± 0.052. An AGW was seen in 100% of the rabbits survived in the MMC group (n = 2) with the 60% (n = 3) of the MMC rabbits expired due to postprocedure infections. The average AGW ratio was 0.28 ± 0.070 in the MMC group. AGW formation rate was 50% in HF group with one rabbit expired from infection. Mean AGW ratio was lowest in the HF group (0.23 ± 0.10; P = 0.013). Microscopically, AGW induction sites in HF-treated rabbits displayed significantly fewer collagen fibers (P = 0.009) by comparison.
This is the first reported use of a cross-linked hyaluronic acid gel that may prevent AGW formation.
N/A. Laryngoscope, 126:2320-2324, 2016.
目的/假设：验证一种预防前声门粘连（AGW）形成的抗粘连策略。
对家兔进行前瞻性动物研究。
将15只新西兰白兔随机分为三组，每组5只，分别向通过喉裂开技术诱导的AGW（此前我们已报道过）应用HyFence（HF：0.1 g/声带），一种抗粘连测试剂；丝裂霉素C（MMC：1 mg/ml, 使用4分钟）作为对照治疗；或生理盐水（对照组）。在第8周时，测量AGW的程度以评估HF和MMC的预防效果，并采集喉部标本进行高速记录和组织学分析。
所有5只（100%）对照兔的AGW诱导均成功，每只在前连合处均显示有纤维结缔组织和胶原纤维，AGW比例平均为0.57±0.052。MMC组存活的兔子中100%出现AGW（n = 2），60%（n = 3）的MMC组兔子因术后感染死亡。MMC组的平均AGW比例为0.28±0.070。HF组的AGW形成率为50%，有1只兔子因感染死亡。HF组的平均AGW比例最低（0.23±0.10；P = 0.013）。显微镜下，相比之下，HF处理的兔子中AGW诱导部位的胶原纤维明显更少（P = 0.009）。
这是首次报道使用交联透明质酸凝胶预防AGW形成。
无。《喉镜》，2016年，第126卷，第2320 - 2324页
