Laryngeal Thermal Injury Model
Laryngeal Thermal Injury Model
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DOI：
10.1093/jbcr/iraa009
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发表时间：
2020-05-01
影响因子：
1.4
通讯作者：
Christensen, Christine L.
中科院分区：
文献类型：
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作者：
Dion, Gregory R.;Pingree, Christian S.;Christensen, Christine L.
缺乏可靠的喉部热损伤模型阻碍了喉部烧伤伤口愈合研究和新疗法的研究。我们假设猪喉部烧伤模型可以随着时间的推移对喉部烧伤进行评估。 12 只约克夏杂交猪接受了气管切开术，并使用热空气（150-160 摄氏度）进行内窥镜引导的喉部烧伤。在 12 小时、1、3、7、14 和 21 天时对猪喉进行评估和切片/染色。经委员会认证的兽医病理学家使用九个标准组织学损伤评分量表评估解剖区域（左侧和右侧：会厌、真/假声带和声门下）。六头猪在预定终点被安乐死，三头过早（气道问题），三头在 16 至 36 小时后死于气道并发症。预定终点的内窥镜和肉眼检查显示大量声门上水肿和组织损伤，特别是杓状软骨周围，经声门延伸。过早终点的猪自始至终水肿相对增加。显微镜评估记录了受伤严重程度评分与受伤时间之间的反比关系。炎症严重程度随着时间的推移而降低，14 天时几乎消失。早期以中性粒细胞为主，第 3 天出现组织细胞。肉芽组织在 3 天时出现，早期会厌和/或声门下纤维化在 7 天时出现，并在 14 天时成熟。水肿最初很丰富，第 3 天减少，第 7 天消退。这种方法是第一个提供喉部热损伤纵向分析的方法，反映了喉部热损伤中一些第一个颞部伤口愈合特征数据，并为未来的治疗研究提供了平台。
A lack of reliable laryngeal thermal injury models precludes laryngeal burn wound healing studies and investigation of novel therapeutics. We hypothesize that a swine laryngeal burn model can allow for laryngeal burn evaluation over time. Twelve Yorkshire crossbreed swine underwent tracheostomy and endoscopically directed laryngeal burns using heated air (150-160 degrees C). Swine larynges were evaluated and sectioned/stained at 12 hours, 1, 3, 7, 14, and 21 days. A board-certified veterinary pathologist assessed anatomic regions (left and right: epiglottis, true/false vocal folds, and subglottis) using a nine criteria histological injury scoring scale. Six swine were euthanized at scheduled endpoints, three prematurely (airway concerns), and three succumbed to airway complications after 16 to 36 hours. Endoscopic and gross examination from scheduled endpoints revealed massive supraglottic edema and tissue damage, particularly around the arytenoids, extending transglottically. Swine from premature endpoints had comparatively increased edema throughout. Microscopic evaluation documented an inverse relationship between injury severity score and time from injury. Inflammation severity decreased over time, nearly resolving by 14 days. Neutrophils predominated early with histiocytes appearing at 3 days. Granulation tissue appeared at 3 days, and early epiglottic and/or subglottic fibrosis appeared by 7 days and matured by 14 days. Edema, abundant initially, decreased by day 3 and resolved by day 7. This approach is the first to provide longitudinal analysis of laryngeal thermal injuries, reflecting some of the first temporal wound healing characteristic data in laryngeal thermal injuries and providing a platform for future therapeutic studies.