Endoscopic Sealing With a Polyglycolic Acid Sheet for Restoration of Vocal Fold Mucosa in Dogs

Abstract

Objectives/Hypothesis Voice outcomes of cordectomy for early glottic cancer are often poor due to vocal fold scarring and tissue defects. Improvements in this aspect could make cordectomy a more acceptable treatment option than radiotherapy. We hypothesized that a polyglycolic acid (PGA) sheet could be used to cover vocal fold defects. The present study aimed to prevent vocal fold scarring after cordectomy using the PGA sheet. Study Design Animal experiment. Methods Nine male beagles were divided into three groups including a control group (n = 3). Following cordectomy, the vocal fold defect was covered with the PGA sheet plus fibrin glue (PGA group; n = 3) or with the PGA sheet plus fibrin glue containing basic fibroblast growth factor (bFGF; the PGA‐bFGF group, n = 3). Vocal folds were chronologically observed, and larynges were removed 6 months after surgery. Mucosal amplitude was measured using a high‐speed camera, and histological analysis was performed. Results The re‐epithelialization process was delayed in the PGA and PGA‐bFGF groups compared with the control group. The mucosal amplitude was significantly more normalized and the thickness ratio significantly higher in the PGA and PGA‐bFGF groups compared with the control group. The PGA‐bFGF group had the highest elastic fiber density, followed by the PGA group and then the control group, with a significant difference between the PGA‐bFGF and control groups. Conclusions The PGA sheet plus fibrin glue could serve as an effective regenerative scaffold for reconstructing vocal fold morphology and function after cordectomy, with the potential benefit of establishing an endoscopic sealing method for vocal fold defects. Level of Evidence NA Laryngoscope, 130:E436–E443, 2020

Application of polyglycolic acid sheets and basic fibroblast growth factor to prevent esophageal stricture after endoscopic submucosal dissection in pigs

“…Mihashi et al excised the vocal cords of dogs and applied bFGF-soaked PGA sheets to the wound. As a result, the vocal cords were regenerated functionally and histologically, similar to normal tissue in terms of thickness and density [ 53 ]. Moreover, this study did not confirm the activation of the inflammatory response and immune system by the administration of PGA sheets or bFGF.…”

Induction of angiogenesis and neural progenitor cells by basic fibroblast growth factor‐releasing polyglycolic acid sheet following focal cerebral infarction in mice

“…In neurosurgery, PGA nonwoven fabric is used as an artificial dura mater to prevent air and cerebrospinal fluid leaks during surgery 17 . Although the combined use of PGA nonwoven fabric sheets and bFGF for tissue regeneration and epithelization has been reported, 18 little is known about the therapeutic effects on cerebral infarction. In this study, we prepared bFGF‐releasing PGA nonwoven fabric sheets containing varying amounts of bFGF and investigated their effect on cerebral infarction in a mouse model.…”