Ford C N, Staskowski P A, Bless D M
University of Wisconsin Clinical Science Center, Madison, WI 53792, USA.
Laryngoscope. 1995 Sep;105(9 Pt 1):944-8. doi: 10.1288/00005537-199509000-00014.
This preliminary study reports the first use of injectable autologous collagen for vocal fold augmentation. In previous studies, the authors showed cross-linked bovine collagen to be effective in more than 150 patients with glottic incompetence, particularly those with focal defects or scarred or atrophic vocal folds. However, concerns about possible adverse immunologic responses to the bovine material have limited its use. The authors studied eight patients with difficult vocal fold pathology, including sulcus vocalis, atrophy, and scarring secondary to trauma and cordectomy. Skin was harvested under local anesthesia, processed into a naturally cross-linked injectable form (Autologen), and injected using indirect laryngoscopy. Voice production was evaluated prior to the injection and at intervals after the injection, using subjective, perceptual, aerodynamic, acoustic, and videostroboscopic assessments. The results indicate that autologous collagen is comparable to injectable bovine collagen in the management of several difficult glottic insufficiency problems and that the likelihood of a hypersensitivity response is negligible. Unlike bovine collagen preparations, Autologen does not require breakdown of the natural collagen molecule, so it is anticipated that this material will be better tolerated and more stable over time.
这项初步研究报告了首次将可注射自体胶原蛋白用于声带增厚。在先前的研究中，作者表明交联牛胶原蛋白对150多名声门功能不全患者有效，特别是那些有局灶性缺陷、瘢痕化或萎缩性声带的患者。然而，对牛材料可能产生的不良免疫反应的担忧限制了其应用。作者研究了8例声带病变复杂的患者，包括声带沟、萎缩以及创伤和声带切除术继发的瘢痕形成。在局部麻醉下采集皮肤，加工成天然交联的可注射形式（自体胶原蛋白），并通过间接喉镜进行注射。在注射前以及注射后的不同时间间隔，使用主观、感知、空气动力学、声学和频闪喉镜评估来评估发声情况。结果表明，在处理几种复杂的声门功能不全问题时，自体胶原蛋白与可注射牛胶原蛋白相当，并且过敏反应的可能性可以忽略不计。与牛胶原蛋白制剂不同，自体胶原蛋白不需要破坏天然胶原蛋白分子，因此预计这种材料随着时间的推移将具有更好的耐受性和更高的稳定性。
