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The effects of cryotherapy on vocal fold healing in a rabbit model
Author(s) -
Gong Ting,
Zhang Chi,
Kang Jing,
Lou Zhewei,
Scholp Austin,
Jiang Jack J.
Publication year - 2019
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.27629
Subject(s) - cryotherapy , medicine , hyaluronic acid , lamina propria , wound healing , extracellular matrix , pathology , fibrosis , vocal folds , surgery , anatomy , epithelium , larynx , biology , microbiology and biotechnology
Objectives/Hypothesis Cryotherapy has been shown to be a scarless treatment modality for dermal lesions; however, there are limited data addressing the effect of cryotherapy on vocal fold tissue. The aim of this study was to clarify the effectiveness of cryotherapy for prevention of postsurgical vocal fold scarring. Study Design Prospective animal study in rabbits. Methods The lamina propria of 20 rabbit vocal folds was bilaterally stripped, followed by randomized unilateral cryotherapy. Five larynges were harvested for real‐time polymerase chain reaction (RT‐PCR) analysis at 1 day, 3 days, and 7 days postinjury. The remaining five were harvested for histologic analysis at 3 months. Images of the healing phase were recorded by laryngoscopy. Analyses of RT‐PCR for cyclooxygenase (COX)‐2, interleukin (IL)‐6, collagen I, collagen III, matrix metallopeptidase 1 (MMP1), transforming growth factor β (TGFβ1), α smooth muscle actin (α‐SMA), and hyaluronan synthase 1 (HAS1) were completed. Histological samples were completed for collagen and hyaluronic acid analysis. Results RT‐PCR results revealed that higher expressions of HAS1 and MMP1 and lower expressions of COX‐2, IL‐6, collagen I, collagen III, TGFβ1, and α‐SMA were observed, and histological examination showed significantly increased hyaluronic acid, decreased deposition, and more organized configuration of collagen in injury with the cryotherapy cohort compared with the injury cohort. Conclusions Cryotherapy can inhibit the inflammatory reaction and simulate a fetal healing environment in extracellular matrix synthesis to regenerate vocal fold tissue with less fibrosis. Histological results showed that cryotherapy achieves a mature healing result with less scar, which tends to return to normal. In summary, the findings of this study suggest that administration of cryotherapy at the time of injury has the potential to minimize vocal fold scarring. Level of Evidence NA Laryngoscope , 129:E151–E157, 2019