Abstract
Problem: To examine the effectiveness of an auto-crosslinked polysaccharide (ACP) hyaluronan-based gel for the treatment of acute vocal fold scar in a canine animal model.
Methods: Twelve canine larynges were injured by unilateral stripping of the vocal fold mucosa, from the epithelium down to the thyroarytenoid muscle. Six of these animals were treated with a transcutaneous injection of ACP gel (30 mg) into the thyroarytenoid muscle and remaining lamina propria at the time of injury, and again at 7 and 14 days postoperatively. The remaining animals were treated with an injection of sodium chloride to serve as sham controls. All animals were euthanized 2 months following the initial treatment. Excised larynx experiments were completed to obtain phonation threshold pressure (PTP) and vocal economy an acoustic output cost ratio (OCR), followed by histologic analysis for hyaluronan and collagen between the scarred and control vocal fold.
Results: Dense, thick bundle collagen was observed on the injured side of sham-treated larynges. Minimal collagen deposition was observed on the injured side of ACP-treated larynges. PTP was lower and OCR was higher in the ACP-treated animals.
Conclusion: ACP-treated larynges revealed greater ease of phonation and better vocal economy than sham-treated larynges. Collagen deposition was less dense in ACP-treated larynges. ACP gel provided sufficient bulk to the scarred vocal fold.
Significance: ACP gel may provide a useful bio-injectable substance for improving rheologic tissue and aerodynamic properties for phonation in the scarred larynx.
Support: None reported.
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