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Published on: January 20, 2010
Simulated reflux and laryngotracheal reconstruction: a rabbit model
J D Carron1, J H Greinwald, J P Oberman
1Department of Otolaryngology-Head and Neck Surgery, Eastern Virginia Medical School, Norfolk, VA 23507, USA. jdcarron@yahoo.com
Archives of Otolaryngology--Head & Neck Surgery
|May 18, 2001
Summary
This study developed a rabbit model to simulate gastroesophageal reflux (GER) after laryngotracheal reconstruction. While GER increased inflammation at pH 4.0, cartilage necrosis was common, and the model needs refinement for better outcomes.
Area of Science:
- Otolaryngology
- Surgical Research
- Animal Models
Background:
- Gastroesophageal reflux (GER) is a potential complication after laryngotracheal reconstruction.
- A reliable animal model is needed to study GER's effects on this procedure.
Purpose of the Study:
- To establish a rabbit model using a pharyngostomy tube to simulate GER.
- To investigate the impact of simulated GER on laryngotracheal reconstruction outcomes in rabbits.
Main Methods:
- A prospective randomized trial involved 33 New Zealand white rabbits undergoing anterior cartilage laryngotracheoplasty and pharyngostomy tube placement.
- Simulated GER was induced using hydrochloric acid with pepsin at pH 1.5 or 4.0, or saline control, irrigated via the pharyngostomy tube.
- Pathological inflammation scoring and airway/graft measurements were performed.
Main Results:
- Significantly higher inflammation scores were observed in the pH 4.0 GER group (P=.04).
- Cartilage necrosis was prevalent across all groups.
- No significant differences in airway lumen or cartilage graft size were found between groups.
Conclusions:
- Early stages of laryngotracheoplasty show prominent cartilage necrosis.
- Simulated GER can increase inflammation, but the effect is pH-dependent and difficult to predict.
- The rabbit model is feasible but requires modifications for improved survival and data acquisition.
