Ronis M L, Harwick J D, Fung R, Dellavecchia M
Laryngoscope. 1984 Feb;94(2 Pt 1):210-3. doi: 10.1288/00005537-198402000-00012.
Cyanoacrylates were first synthesized by Ardis in 1949. However, it was not until Coover in 1959 discovered their adhesive properties that an interest arose in using these substances in surgical procedures. Over the past two decades the use of cyanoacrylates has been varied and widespread among the surgical specialties. methyl 2-cyanoacrylate (Eastman 910 Monomer), Isobutyl-cyanoacrylate (Bucrylate), and 2-cyano-butyl-acrylate (Histoacryl) were the most widely used. Because of its tissue toxicity methyl 2-cyanoacrylate was discarded. The consensus of various investigators was that the higher homologues, in particular Histoacryl could be safely used in human applications. The authors thought it would be important to ascertain how the academic departments of Otolaryngology perceived the role of cyanoacrylates within their specialty. A questionnaire was distributed to 115 academic centers: 47% of the departments responded and, of those, 34% indicated a current working knowledge of the cyanoacrylates. This response confirmed a very active interest in these tissue adhesives despite a lack of F.D.A. approval. The otologic applications of these adhesives has been well documented, but the literature is devoid of studies using cyanoacrylates in other aspects of Otolaryngology. The authors feel that these adhesives (in particular Histoacryl) have a role as an adjunctive technique in facial reconstructive and cosmetic surgery for autogenous cartilage grafting. A study using rabbits was designed to determine if Histoacryl could be used safely to overcome the technical difficulties (graft migration during healing and cartilage fracture during suturing) often encountered when performing autogenous onlay cartilage grafting. On the left ear of each rabbit, a cartilage graft was harvested and reimplanted at a second site on the same ear by suturing the perichondrium of the graft to the perichondrium of the donor site. On the right ear the graft was secured to the donor site with Histoacryl. The histological analysis of the rabbits' ears sacrificed at weekly intervals from 1 week to 1 month failed to demonstrate cartilage damage or tissue toxicity in the ears where Histoacryl was used. In conclusion, the authors contend that a role exists for the use of Histoacryl as an adjunctive technique in facial reconstructive and cosmetic surgery. The study will be continued to assess the long-term results of using Histoacryl for autogenous onlay cartilage grafting.
氰基丙烯酸酯最早由阿尔迪斯于1949年合成。然而，直到1959年库弗发现它们的粘合特性后，人们才开始对在外科手术中使用这些物质产生兴趣。在过去的二十年里，氰基丙烯酸酯在外科专业中的应用广泛且多样。甲基2 - 氰基丙烯酸酯（伊士曼910单体）、异丁基氰基丙烯酸酯（布克里特）和2 - 氰基丁基丙烯酸酯（组织黏合剂）是使用最广泛的。由于甲基2 - 氰基丙烯酸酯具有组织毒性，它被淘汰了。众多研究者的共识是，更高同系物，特别是组织黏合剂，可以安全地用于人体。作者认为确定耳鼻喉科各学术部门如何看待氰基丙烯酸酯在其专业领域中的作用很重要。向115个学术中心发放了问卷：47%的部门回复了，其中34%表示对氰基丙烯酸酯有当前的实用知识。这一回复证实了尽管缺乏美国食品药品监督管理局的批准，但人们对这些组织黏合剂仍有非常浓厚的兴趣。这些黏合剂在耳科的应用已有充分记录，但文献中缺乏在耳鼻喉科其他方面使用氰基丙烯酸酯的研究。作者认为这些黏合剂（特别是组织黏合剂）在面部重建和美容手术中自体软骨移植方面可作为一种辅助技术发挥作用。设计了一项使用兔子的研究，以确定组织黏合剂是否可安全用于克服自体覆盖软骨移植时经常遇到的技术难题（愈合过程中移植物移位和缝合时软骨骨折）。在每只兔子的左耳，采集一块软骨移植物，并通过将移植物的软骨膜缝合到供体部位的软骨膜上，将其重新植入同一只耳朵的另一个部位。在右耳，用组织黏合剂将移植物固定到供体部位。对从1周到1个月每周处死的兔子耳朵进行组织学分析，未发现使用组织黏合剂的耳朵有软骨损伤或组织毒性。总之，作者认为组织黏合剂在面部重建和美容手术中作为辅助技术有其作用。该研究将继续进行，以评估使用组织黏合剂进行自体覆盖软骨移植的长期效果。
