Effects of Inhaled Dexamethasone/Ciprofloxacin on Acute Subglottic Stenosis in a Rabbit Model

IF 1.6 4区医学 Q2 OTORHINOLARYNGOLOGY

Laryngoscope Investigative Otolaryngology Pub Date : 2025-04-25 DOI:10.1002/lio2.70119

I-Chun Kuo, Catherine K. Hart, Isabelle M. Gengler, Alessandro de Alarcón

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Abstract

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.

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吸入地塞米松/环丙沙星对兔急性声门下狭窄模型的影响

目的声门下狭窄（SGS）是气道干预后的一个具有挑战性的并发症。有效的预防战略缺乏足够的证据。研究了地塞米松/环丙沙星吸入治疗对兔急性SGS模型的预防作用。方法20只新西兰大白兔经内窥镜对其进行声门下损伤，自损伤日起每日2次给予吸入治疗。第1组（n = 4）给予生理盐水5 d，第5天处死；组2 （n = 4）接受地塞米松/环丙沙星治疗5 d，第5天处死；第三组（n = 4）给予相同治疗5 d，存活1周，第15天处死；第4组（n = 4）给予治疗10 d，第15天处死；第5组（n = 4），治疗10 d，存活1周，第22天处死。兔重复内镜检查，并在指定时间点安乐死。对组织学指标进行统计学分析。结果组1、组2、组14.84±2.55 mm2、组4、组17.18±5.31 mm2、组5环状膜中腔测量值分别为20.01±1.42 mm2、17.94±3.05 mm2、11.87±5.68 mm2。治疗组与对照组之间无显著差异（p = 0.486），治疗5天与10天之间无显著差异（p = 0.686）。多因素统计分析表明，停止吸入治疗（p < 0.05）和延长生存期（p < 0.05）与环状环管腔测量值缩短有关。结论短期吸入地塞米松/环丙沙星对急性SGS无预防作用。环状管腔直径未见改善。延长的生存期与较短的环状管腔相关，提示SGS的进展与时间有关。证据水平NA。

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