Triglia J M, Scheiner C, Gouvernet J, Cannoni M
Division of Pediatric Otorhinolaryngology, Marseille University Medical School, France.
Arch Otolaryngol Head Neck Surg. 1993 Jan;119(1):87-91. doi: 10.1001/archotol.1993.01880130089013.
Current concepts in laryngotracheal reconstruction include lumen augmentation with interposition of autogenous costal cartilage. In an effort to reduce potential increased morbidity at the donor site, the use of porous hydroxyapatite was compared with autogenous costal cartilage in an experimental study. Ninety-nine New Zealand rabbits were randomly operated on to receive autogenous costal cartilage (n = 32), hydroxyapatite covered by a perichondrium graft (n = 33), or hydroxyapatite alone (n = 34). Rabbits were killed at 3 months after the surgery. Clinically (n = 85), no difference was found among the groups. Histologically (n = 81), grafts (n = 54) in the group receiving autogenous costal cartilage were greater than in those receiving the hydroxyapatite. Concerning the value of epithelial layer covering the graft, the rate of inflammation, the cricoid-graft interface, and the graft viability, no difference was noted among the groups. In the group in which no graft was found (n = 27), a fibrous bridge maintaining a cricoid distraction was noted in 23 cases. This study shows the possible value of hydroxyapatite in the animal model, but before clinical application, the natural course of the fibrous bridge must be documented.
当前喉气管重建的概念包括使用自体肋软骨植入来扩大管腔。为了降低供体部位潜在的发病率增加，在一项实验研究中，将多孔羟基磷灰石与自体肋软骨进行了比较。99只新西兰兔被随机进行手术，分别接受自体肋软骨（n = 32）、覆盖有软骨膜移植物的羟基磷灰石（n = 33）或单独的羟基磷灰石（n = 34）。术后3个月处死兔子。临床观察（n = 85）发现各组之间无差异。组织学观察（n = 81）发现，接受自体肋软骨组的移植物（n = 54）大于接受羟基磷灰石组。关于覆盖移植物的上皮层价值、炎症发生率、环状软骨-移植物界面以及移植物活力，各组之间未发现差异。在未发现移植物的组（n = 27）中，23例发现有维持环状软骨牵张的纤维桥。本研究显示了羟基磷灰石在动物模型中的潜在价值，但在临床应用之前，必须记录纤维桥的自然病程。
