Santos Fernanda da Silva, Ikeda Felipe Hideo, Barros Mirna Duarte, Duprat André de Campos
Irmandade da Santa Casa de Misericórdia de São Paulo, Departamento de Otorrinolaringologia, São Paulo, SP, Brazil.
Irmandade da Santa Casa de Misericórdia de São Paulo, Departamento de Otorrinolaringologia, São Paulo, SP, Brazil.
Braz J Otorhinolaryngol. 2022 Nov-Dec;88 Suppl 1(Suppl 1):S102-S107. doi: 10.1016/j.bjorl.2021.04.005. Epub 2021 May 6.
A challenge in phonosurgery is achieving good vocal quality with minimal vocal fold fibrosis. Fibrin glue can be applied to minimize fibrosis; however, its use in the larynx is based primarily on clinical experience, particularly in extensive lesions.
The objective of this study was to evaluate the effect of application of fibrin glue on collagen concentration at the late phase of the healing process after detaching a pedicled flap of the vocal fold cover in rabbits.
In this prospective animal study, twelve adult male rabbits underwent laryngeal microsurgery, in which an incision was made along the entire length of both vocal folds, followed by extensive mucosal detachment and section of the incision ends. Fibrin glue was applied in the left vocal fold, and the mucosa was repositioned. In the right vocal fold, the mucosa was repositioned without treatment with fibrin glue. After 3-months, the rabbits were euthanized. Histological analyses were performed, and the data collected were subjected to statistical analysis.
Vocal folds treated with fibrin glue presented higher collagen concentration in Masson trichrome staining and significantly higher (p < 0.05) collagen concentration in picrosirius red staining compared to control vocal folds.
Treatment with fibrin glue led to greater vocal fold fibrogenesis in the present study. Nonetheless, further studies are necessary to determine the prophylactic effect of sealants in laryngeal surgeries that require extensive detachment of the vocal fold cover.
嗓音外科面临的一项挑战是在声带纤维化程度最低的情况下实现良好的嗓音质量。纤维蛋白胶可用于减少纤维化;然而,其在喉部的应用主要基于临床经验,尤其是在广泛病变的情况下。
本研究的目的是评估在兔声带覆盖物带蒂皮瓣分离后愈合过程的后期,应用纤维蛋白胶对胶原浓度的影响。
在这项前瞻性动物研究中,12只成年雄性兔接受了喉显微手术,沿双侧声带全长做切口,随后进行广泛的黏膜分离并切断切口两端。在左侧声带应用纤维蛋白胶,然后将黏膜复位。右侧声带则不使用纤维蛋白胶进行黏膜复位。3个月后,对兔实施安乐死。进行组织学分析,并对收集的数据进行统计分析。
与对照声带相比,应用纤维蛋白胶处理的声带在马松三色染色中呈现出更高的胶原浓度,在苦味酸天狼星红染色中胶原浓度显著更高(p<0.05)。
在本研究中,应用纤维蛋白胶治疗导致声带纤维化程度更高。尽管如此,仍需要进一步研究以确定密封剂在需要广泛分离声带覆盖物的喉部手术中的预防效果。