可注射物质对手术损伤兔声带的功能分析。
Functional Analysis of Injectable Substance Treatment on Surgically Injured Rabbit Vocal Folds.
机构信息
Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.
Department of Mechanical Engineering, McGill University, Montreal, Quebec, Canada.
出版信息
J Voice. 2023 Nov;37(6):829-839. doi: 10.1016/j.jvoice.2021.06.001. Epub 2021 Aug 2.
OBJECTIVES
The objective of this study was to evaluate the efficacy of immediate injection treatments of dexamethasone, hyaluronic acid (HA)/gelatin (Ge) hydrogel and glycol-chitosan solution on the phonatory function of rabbit larynges at 42 days after surgical injury of the vocal folds, piloting a novel ex vivo phonatory functional analysis protocol.
METHODS
A modified microflap procedure was performed on the left vocal fold of 12 rabbits to induce an acute injury. Animals were randomized into one of four treatment groups with 0.1 mL injections of dexamethasone, HA/Ge hydrogel, glycol-chitosan or saline as control. The left mid vocal fold lamina propria was injected immediately following injury. The right vocal fold served as an uninjured control. Larynges were harvested at Day 42 after injection, then were subjected to airflow-bench evaluation. Acoustic, aerodynamic and laryngeal high-speed videoendoscopy (HSV) analyses were performed. HSV segments of the vibrating vocal folds were rated by three expert laryngologists. Six parameters related to vocal fold vibratory characteristics were evaluated on a Likert scale.
RESULTS
The fundamental frequency, one possible surrogate of vocal fold stiffness and scarring, was lower in the dexamethasone and HA/Ge hydrogel treatment groups compared to that of the saline control (411.52±11.63 Hz). The lowest fundamental frequency value was observed in the dexamethasone group (348.79±14.99 Hz). Expert visual ratings of the HSV segments indicated an overall positive outcome in the dexamethasone treatment group, though the impacts were below statistical significance.
CONCLUSION
Dexamethasone injections might be used as an adjunctive option for iatrogenic vocal fold scarring. An increased sample size, histological correlate, and experimental method improvements will be needed to confirm this finding. Results suggested a promising use of HSV and acoustic analysis techniques to identify and monitor post-surgical vocal fold repair and scarring, providing a useful tool for future studies of vocal fold scar treatments.
目的
本研究旨在评估地塞米松、透明质酸（HA）/明胶（Ge）水凝胶和乙二醇壳聚糖溶液在声带手术后 42 天对兔喉发声功能的即时注射治疗效果，同时探索一种新的离体发声功能分析方案。
方法
对 12 只兔子的左侧声带进行改良微瓣手术以诱导急性损伤。动物随机分为四组，每组 0.1 mL 注射地塞米松、HA/Ge 水凝胶、乙二醇壳聚糖或生理盐水作为对照。损伤后立即对左侧声带固有层进行注射。右侧声带作为未受伤的对照。注射后第 42 天收获喉，然后进行气流台评估。进行声学、空气动力学和喉高速视频内镜（HSV）分析。三位专家喉科医生对振动声带的 HSV 节段进行评分。对与声带振动特征相关的六个参数进行李克特量表评估。
结果
与生理盐水对照组相比，地塞米松和 HA/Ge 水凝胶治疗组的基频（可能是声带僵硬和瘢痕的替代指标）较低（411.52±11.63 Hz）。地塞米松组的基频最低（348.79±14.99 Hz）。HSV 节段的专家视觉评分表明地塞米松治疗组整体结果呈阳性，但影响未达到统计学意义。
结论
地塞米松注射可能作为医源性声带瘢痕的辅助治疗选择。需要增加样本量、组织学相关性和实验方法改进，以证实这一发现。结果表明，HSV 和声学分析技术可用于识别和监测声带手术后的修复和瘢痕形成，为未来的声带瘢痕治疗研究提供有用的工具。
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