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Effects of Inhaled Dexamethasone/Ciprofloxacin on Acute Subglottic Stenosis in a Rabbit Model
I-Chun Kuo1,2, Catherine K Hart3,4, Isabelle M Gengler4
1Department of Otolaryngology-Head & Neck Surgery Chang Gung Memorial Hospital Taoyuan Taiwan.
Objectives:
Subglottic stenosis (SGS) is a challenging complication post-airway interventions. Effective preventive strategies lack sufficient evidence. This study investigated the preventive effect of inhalation therapy with dexamethasone/ciprofloxacin on acute SGS in a rabbit model.
Methods:
Twenty New Zealand White rabbits underwent subglottic injury via endoscopy and received inhalation therapy twice daily starting on the injury day. Group 1 (n = 4) received saline for 5 days and was sacrificed on day 5; Group 2 (n = 4) received dexamethasone/ciprofloxacin for 5 days and was sacrificed on day 5; Group 3 (n = 4) received the same therapy for 5 days and survived for one week, and was sacrificed on day 15; Group 4 (n = 4) received the therapy for 10 days and was sacrificed on day 15; Group 5 (n = 4) received the therapy for 10 days and survived for one week, and was sacrificed on day 22. Rabbits underwent repeat endoscopy and were euthanized at the designated time point. Histological measurements were analyzed statistically.
Results:
Histological analysis revealed median cricoid lumen measurements of 20.01 ± 1.42 mm2 for group 1, 17.94 ± 3.05 mm2 for group 2, 14.84 ± 2.55 mm2 for group 3, 17.18 ± 5.31 mm2 for group 4, and 11.87 ± 5.68 mm2 for group 5. No significant differences were found between treatment and control groups (p = 0.486) or between 5-day and 10-day treatments (p = 0.686). Multivariate statistical analysis indicated that cessation of inhalation therapy (p < 0.05) and prolonged survival (p < 0.05) were associated with shorter cricoid lumen measurements.
Conclusion:
Short-term dexamethasone/ciprofloxacin inhalation does not prevent acute SGS. No improvements in cricoid lumen diameter were found. Extended survival correlated with shorter cricoid lumen, suggesting SGS progression is time dependent.
Level Of Evidence:
NA.
Insights
Inhaled dexamethasone/ciprofloxacin did not prevent subglottic stenosis (SGS) in rabbits. Longer survival times were linked to smaller airway openings, indicating SGS worsens over time.
Area of Science:
- Otolaryngology
- Pulmonology
- Medical Research
Background:
- Subglottic stenosis (SGS) is a significant complication following airway interventions.
- Current evidence for effective preventive strategies for acute SGS is limited.
Purpose of the Study:
- To investigate the potential preventive effects of inhaled dexamethasone/ciprofloxacin on acute subglottic stenosis.
- To evaluate the impact of treatment duration and survival time on SGS development in a rabbit model.
Main Methods:
- New Zealand White rabbits underwent endoscopic subglottic injury.
- Inhalation therapy with dexamethasone/ciprofloxacin or saline was administered for 5 or 10 days.
- Histological analysis of cricoid lumen measurements was performed at various time points.
Main Results:
- No significant difference in cricoid lumen measurements was observed between the treatment and control groups.
- Both 5-day and 10-day treatment durations showed no significant difference in preventing SGS.
- Multivariate analysis revealed that cessation of therapy and prolonged survival were associated with reduced cricoid lumen size.
Conclusions:
- Short-term inhalation therapy with dexamethasone/ciprofloxacin does not prevent acute subglottic stenosis in this rabbit model.
- The study suggests that SGS progression is time-dependent, as longer survival correlated with smaller airway lumens.
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