<scp>MRI</scp> Study of Jellyfish Collagen, Hyaluronic Acid, and Cadaveric Dermis for Injection Laryngoplasty

San‐Marina, Serban; Bowen, Andrew J.; Oldenburg, Michael S.; Voss, Stephen G.; Hunter, Danielle E.; Macura, Slobodan; Meloche, Ryan; Miller, Alen Lee; Spragg, Andrew Mearns; Ekbom, Dale C.

doi:10.1002/lary.29501

Cited by 6 publications

(20 citation statements)

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“…MRI imaging is now more readily available and economically feasible for lab experimentation at our institution, as is occurring at most major institutions in the United States. For this reason, we proceeded to use this imaging modality to estimate the residual volume of JC in a rabbit model 7 . Our desire to use this imaging modality was partially motivated by animal experiments using this modality to assess the intrinsic behavior of injection laryngoplasty material with the native laryngeal parenchyma 8–10 .…”

Section: Discussionmentioning

confidence: 99%

“…The animal model used in this investigation and the methodology employed for completing these experiments are described in a recently completed investigation 7 . It will be briefly highlighted below.…”

Section: Methodsmentioning

confidence: 99%

“…Following a 2‐week recovery, animals were re‐anesthetized and received left IL with 100 μl of JC (225 mg/ml), MACD (275 mg/ml), or X‐HA (20 mg/ml). Injections of 100 μl were placed lateral to the vocal process as described before 7 . One animal in the Restylane group received 110 μl.…”

Section: Methodsmentioning

confidence: 99%

“…Prepared laryngeal specimens underwent MRI analysis using an Avance III 300 MHz (7 Tesla) wide bore NMR spectrometer equipped with micro‐imaging accessories (Bruker, BioSpin, Billerica, MA) and a 20 mm diameter volume coil. Samples were prepared and imaged as described previously 7 . A multi‐slice image collection of 26 separate 0.5 mm thick digital cross sections of the larynx starting from the cricothyroid cartilage moving superiorly to the end of the specimen was generated for each animal.…”

Section: Methodsmentioning

confidence: 99%

“…More recently we reported on our investigation of a novel jellyfish collagen substance (JC; Jellagen®) for IL, using MRI for volume estimation 7 . While MRI was not previously used for this purpose, there is experience with it for examining the relationship between foreign injected material and the native laryngeal parenchyma 8–10 .…”

Section: Introductionmentioning

confidence: 99%

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MRI imaging versus histologic volumetric estimation of residual injection laryngoplasty material

Bowen

San‐Marina

Hunter

et al. 2022

Laryngoscope Investig Oto

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Objectives: To examine the degree of agreement between MRI and histologically generated volumetric measurements of residual injection laryngoplasty material.Methods: Following left recurrent laryngeal nerve transection, rabbit vocal cords were injected with jellyfish collagen, Cymetra ® , or Restylane ® . Laryngeal tissue was harvested 4 or 12 weeks post injection followed by MRI imaging and histologic crosssectioning. Two raters estimated the volume of remaining injection material in specimens within MRI and histologic axial cross sections. Wilcoxon signed rank tests were employed to detect gross differences between inter-rater measurements and between imaging modalities across time. Agreement between rater measurements and imaging (histology and MRI) was assessed using intra-class correlation coefficients.Results: Data was available from 16 rabbits sacrificed at 4 weeks (n = 8) and 12 weeks (n = 8). Inter-rater testing of MRI imaging revealed no significant differences (p > .05) between rater measurements across time points, and excellent agreement (0.93; 95% confidence interval 0.80-0.98) while histologically estimated volumes demonstrated a significant difference at 4 weeks (p < .05) and overall good agreement (0.89; 95% confidence interval 0.59-0.97). Comparison of MRI and histologically estimated volume measurements revealed significant differences at the 4-week time point (p < .05) but not at 12 weeks (p > .05). Overall, there is only moderate agreement between MRI and histology estimates (0.72; 95% confidence interval 0.22-0.90).Conclusions: MRI imaging demonstrates good reliability and similar estimates of volume to histologically estimated measurements of residual injection laryngoplasty material at time points clinically relevant for future injection laryngoplasty experiments.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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MRI imaging versus histologic volumetric estimation of residual injection laryngoplasty material

Bowen

San‐Marina

Hunter

et al. 2022

Laryngoscope Investig Oto

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Transcutaneous Laryngeal Ultrasound for Assessing Hyaluronic Acid Status in Patients Undergoing Injection Laryngoplasty

Chang,

Kuo,

Hsu

2024

The Laryngoscope

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ObjectiveInjection laryngoplasty (IL) with hyaluronic acid (HA) is an effective treatment for patients with glottic insufficiency. The duration of HA maintenance in the vocal fold remains unknown. In this study, transcutaneous laryngeal ultrasound (TLUS) was used to evaluate the absorption and migration of HA after IL. Subsequent management might be provided based on the TLUS finding.MethodsPatients diagnosed with unilateral vocal fold paralysis (UVFP) or vocal fold atrophy were recruited. All patients underwent IL with HA in an office‐based setting along with TLUS to monitor the status of HA. The schedule of TLUS included assessments before and after IL until non‐visualization.ResultsThe study population comprised 38 women and 17 men. Of the patients, 54.1% underwent IL for UVFP, whereas 45.9% underwent IL for vocal fold atrophy. Multivariate Cox regression analysis for factors affecting HA absorption revealed that the cause of injection was the most important independent predictor (hazard ratio [HR], 2.15; 95% confidence interval [CI], 1.03–4.46; p = 0.040). The duration of HA maintenance was significantly longer in patients with UVFP than in those with vocal fold atrophy (8.77 vs. 4.70 months, HR, 2.33; 95% CI, 5.47–8.18; p = 0.002).ConclusionTLUS is an objective assessment method for patients undergoing IL with HA. Subsequent tailor‐made management could be offered based on the TLUS findings during follow‐up. For patients at high risk of upper respiratory tract infection or who are intolerant to flexible nasopharyngoscopy, TLUS can be used as an alternative tool to evaluate the condition of the glottis after IL with HA.Level of EvidenceLevel 4 Laryngoscope, 2024

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Larynx proteomics after jellyfish collagen IL: Increased ECM/collagen and suppressed inflammation

Bowen

Ekbom

Hunter

et al. 2022

Laryngoscope Investig Oto

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Objectives/Hypothesis Compare proteomic profiles of rabbit vocal folds (VFs) injected with micronized cross‐linked jellyfish collagen “collagen Type 0” (MX‐JC) against two clinical products for injection medialization laryngoplasty (IL). Study Design Animal model. Methods Left recurrent laryngeal nerve sectioning and IL were performed in New Zealand White rabbits ( N = 6/group). Group 1 received (MX‐JC) and adipose‐derived stem cells (ADSCs), Group 2, MX‐JC alone; Group 3, cross‐linked hyaluronic acid; and Group 4, micronized acellular dermis. Animals were sacrificed at 4 and 12 weeks. Proteomic profiling of injected versus noninjected VFs by nano‐liquid chromatography, tandem mass spectrometry, and reactome gene ontology analysis was performed. Results Overall, 37–61 proteins were found to be upregulated and 60–284 downregulated in injected versus non‐injected VFs (>1.5 fold, false discovery rate‐adjusted p < .05). Over‐representation analysis (% of total) revealed top up‐regulated pathways at 4 and 12 weeks, respectively: Group 1, keratan sulfate metabolism (46%) and cellular processes (29%); Group 2, extracellular matrix (ECM)/collagen processes (33%) and beta oxidation (39%); Group 3, cellular processes (50%) and energy metabolism (100%); and Group 4, keratan sulfate metabolism (31%) and inflammation (50%). Top downregulated pathways were: Group 1, Inflammation (36%) and glucose/citric acid metabolism (42%); Group 2, cell signaling (38%) and glucose/citric acid metabolism (35%); Group 3, keratan sulfate metabolism (31%) and ECM/collagen processes (48%); and Group 4, glucose/citric acid metabolism (33%) and ECM/collagen processes (43%). Conclusions MX‐JC “collagen Type 0” upregulates pathways related to ECM/collagen formation and downregulates pathways related to inflammation suggesting that it is promising biomaterial for IL. Level of Evidence NA

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MRI Study of Jellyfish Collagen, Hyaluronic Acid, and Cadaveric Dermis for Injection Laryngoplasty

Cited by 6 publications

References 24 publications

MRI imaging versus histologic volumetric estimation of residual injection laryngoplasty material

MRI imaging versus histologic volumetric estimation of residual injection laryngoplasty material

Transcutaneous Laryngeal Ultrasound for Assessing Hyaluronic Acid Status in Patients Undergoing Injection Laryngoplasty

Larynx proteomics after jellyfish collagen IL: Increased ECM/collagen and suppressed inflammation

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