Effect of application of fibrin glue on vocal fold healing after surgical manipulation in rabbits

HIGHLIGHTS

Evaluation of prophylactic effect of sealants in laryngeal surgeries that require extensive detachment of the vocal fold cover Prophylactic effect of sealants in laryngeal surgeries.

Incision over the entire length of the vocal fold, followed by anterior and posterior sectioning of the mucosa, creating a pedicled flap. Extensive detachment of the vocal fold cover creating a pedicled flap.

Fibrin glue induced greater fibrogenesis in the vocal fold in a later stage of the healing process. Fibrin glue induced greater fibrogenesis in the vocal fold.

Abstract

Introduction

A challenge in phonosurgery is achieving good vocal quality with minimal vocal fold fibrosis. Fibrin glue can be applied to minimize fibrosis; however, its use in the larynx is based primarily on clinical experience, particularly in extensive lesions.

Objective

The objective of this study was to evaluate the effect of application of fibrin glue on collagen concentration at the late phase of the healing process after detaching a pedicled flap of the vocal fold cover in rabbits.

Methods

In this prospective animal study, twelve adult male rabbits underwent laryngeal microsurgery, in which an incision was made along the entire length of both vocal folds, followed by extensive mucosal detachment and section of the incision ends. Fibrin glue was applied in the left vocal fold, and the mucosa was repositioned. In the right vocal fold, the mucosa was repositioned without treatment with fibrin glue. After 3-months, the rabbits were euthanized. Histological analyses were performed, and the data collected were subjected to statistical analysis.

Results

Vocal folds treated with fibrin glue presented higher collagen concentration in Masson trichrome staining and significantly higher (p< 0.05) collagen concentration in picrosirius red staining compared to control vocal folds.

Conclusion

Treatment with fibrin glue led to greater vocal fold fibrogenesis in the present study. Nonetheless, further studies are necessary to determine the prophylactic effect of sealants in laryngeal surgeries that require extensive detachment of the vocal fold cover.

Keywords
Larynx; Fibrin tissue adhesive; Rabbits; Vocal cords; Fibrosis