Dion Gregory R, Benedict Peter A, Coelho Paulo G, Amin Milan R, Branski Ryan C
NYU Voice Center, Department of Otolaryngology-Head and Neck Surgery, New York University School of Medicine.
Department of Otolaryngology-Head and Neck Surgery, Brooke Army Medical Center, Fort Sam Houston, Texas, U.S.A.
Laryngoscope. 2018 May;128(5):1163-1169. doi: 10.1002/lary.26963. Epub 2017 Oct 9.
OBJECTIVES/HYPOTHESIS: Although the primary goal of medialization laryngoplasty is to improve glottic closure, implant placement is also likely to alter the biomechanical properties of the vocal fold (VF). We sought to employ novel, nanoscale technology to quantify these properties following medialization based on the hypothesis that different medialization materials will likely yield differential biomechanical effects.
Ex vivo.
Nine pig larynges were divided into three groups: control, Silastic (Dow Corning, Midland, Michigan, U.S.A.) block medialization, or Gore-Tex (W.L. Gore & Associates, Newark, Delaware) medialization. Laryngoplasty was performed on excised, intact larynges. The larynges were then bisected in the sagittal plane and each subjected to dynamic nanomechanical analysis (nano-DMA) at nine locations using a 250-μm flat-tip punch and frequency sweep-load profile across the free edge of the VF and inferiorly along the conus elasticus.
Silastic block and Gore-Tex implant introduced increased storage and loss moduli. Overall, storage moduli mean (maximum) increased from 38 kilopascals (kPa) (119) to 72 kPa (422) and 129 kPa (978) in control, Gore-Tex, and Silastic implants, respectively. Similarly, loss moduli increased from 13 kPa (43) to 22 kPa (201) and 31 kPa (165), respectively. Moduli values varied widely by location in the Silastic block and Gore-Tex groups. At the free VF edge, mean (maximum) storage moduli were lowest in the Gore-Tex group, 20 kPa (44); compared to control, 34.5 kPa (86); and Silastic, 157.9 kPa (978), with similar loss and complex moduli trends.
Medialization laryngoplasty altered VF structure biomechanical properties; Silastic and Gore-Tex implants differentially impact these properties.
NA. Laryngoscope, 128:1163-1169, 2018.
目的/假设：尽管喉内移术的主要目标是改善声门闭合，但植入物的放置也可能改变声带（VF）的生物力学特性。我们试图采用新型纳米技术，基于不同的喉内移材料可能产生不同生物力学效应这一假设，来量化喉内移术后的这些特性。
离体研究。
将九个猪喉分为三组：对照组、硅橡胶（美国陶氏化学公司，密歇根州米德兰）块状喉内移组或戈尔特斯（美国戈尔公司，特拉华州纽瓦克）喉内移组。对完整切除的喉部进行喉成形术。然后将喉部在矢状面切开，使用250μm的平头冲头在九个位置对每个样本进行动态纳米力学分析（纳米动态热机械分析），并在声带游离缘及沿弹性圆锥下方进行频率扫描加载分析。
硅橡胶块和戈尔特斯植入物使储能模量和损耗模量增加。总体而言，对照组、戈尔特斯植入物组和硅橡胶植入物组的储能模量平均值（最大值）分别从38千帕（kPa）（119）增加到72 kPa（422）和129 kPa（978）。同样，损耗模量分别从13 kPa（43）增加到22 kPa（201）和31 kPa（165）。在硅橡胶块组和戈尔特斯组中，模量值因位置不同而有很大差异。在声带游离缘，戈尔特斯组的平均（最大）储能模量最低，为20 kPa（44）；与对照组相比为34.5 kPa（86）；与硅橡胶组相比为157.9 kPa（978），损耗模量和复数模量也有类似趋势。
喉内移术改变了声带结构的生物力学特性；硅橡胶和戈尔特斯植入物对这些特性有不同影响。
无。《喉镜》，2018年，第128卷，第1163 - 1169页。
