Kuo I-Chun, Hart Catherine K, Gengler Isabelle M, de Alarcón Alessandro
Department of Otolaryngology-Head & Neck Surgery Chang Gung Memorial Hospital Taoyuan Taiwan.
College of Medicine Chang Gung University Taoyuan Taiwan.
Laryngoscope Investig Otolaryngol. 2025 Apr 25;10(2):e70119. doi: 10.1002/lio2.70119. eCollection 2025 Apr.
Subglottic stenosis (SGS) is a challenging complication post-airway interventions. Effective preventive strategies lack sufficient evidence. This study investigated the preventive effect of inhalation therapy with dexamethasone/ciprofloxacin on acute SGS in a rabbit model.
Twenty New Zealand White rabbits underwent subglottic injury via endoscopy and received inhalation therapy twice daily starting on the injury day. Group 1 ( = 4) received saline for 5 days and was sacrificed on day 5; Group 2 ( = 4) received dexamethasone/ciprofloxacin for 5 days and was sacrificed on day 5; Group 3 ( = 4) received the same therapy for 5 days and survived for one week, and was sacrificed on day 15; Group 4 ( = 4) received the therapy for 10 days and was sacrificed on day 15; Group 5 ( = 4) received the therapy for 10 days and survived for one week, and was sacrificed on day 22. Rabbits underwent repeat endoscopy and were euthanized at the designated time point. Histological measurements were analyzed statistically.
Histological analysis revealed median cricoid lumen measurements of 20.01 ± 1.42 mm for group 1, 17.94 ± 3.05 mm for group 2, 14.84 ± 2.55 mm for group 3, 17.18 ± 5.31 mm for group 4, and 11.87 ± 5.68 mm for group 5. No significant differences were found between treatment and control groups ( = 0.486) or between 5-day and 10-day treatments ( = 0.686). Multivariate statistical analysis indicated that cessation of inhalation therapy ( < 0.05) and prolonged survival ( < 0.05) were associated with shorter cricoid lumen measurements.
Short-term dexamethasone/ciprofloxacin inhalation does not prevent acute SGS. No improvements in cricoid lumen diameter were found. Extended survival correlated with shorter cricoid lumen, suggesting SGS progression is time dependent.
NA.
声门下狭窄（SGS）是气道干预后的一种具有挑战性的并发症。有效的预防策略缺乏充分的证据。本研究在兔模型中调查了地塞米松/环丙沙星吸入疗法对急性SGS的预防作用。
20只新西兰白兔通过内镜进行声门下损伤，并在损伤当天开始每天接受两次吸入治疗。第1组（n = 4）接受生理盐水治疗5天，并在第5天处死；第2组（n = 4）接受地塞米松/环丙沙星治疗5天，并在第5天处死；第3组（n = 4）接受相同治疗5天，存活1周，并在第15天处死；第4组（n = 4）接受治疗10天，并在第15天处死；第5组（n = 4）接受治疗10天，存活1周，并在第22天处死。兔子接受重复内镜检查，并在指定时间点实施安乐死。对组织学测量结果进行统计学分析。
组织学分析显示，第1组环状软骨管腔中位数测量值为20.01±1.42mm，第2组为17.94±3.05mm，第3组为14.84±2.55mm，第4组为17.18±5.31mm，第5组为11.87±5.68mm。治疗组与对照组之间（P = 0.486）或5天与10天治疗组之间（P = 0.686）均未发现显著差异。多变量统计分析表明，停止吸入治疗（P < 0.05）和延长存活时间（P < 0.05）与环状软骨管腔测量值较短有关。
短期吸入地塞米松/环丙沙星不能预防急性SGS。环状软骨管腔直径未发现改善。延长存活时间与较短的环状软骨管腔相关，提示SGS进展与时间相关。
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