Induction of tracheal stenosis in a rabbit model—endoscopic versus open technique§

Authors

  • Matthew K. Steehler MD,

    Corresponding author
    1. Department of Otolaryngology—Head and Neck Surgery , Georgetown University Hospital, Washington, DC, U.S.A.
    • Department of Otolaryngology—Head and Neck Surgery, Georgetown University Hospital, First Floor Gorman Building, 3800 Reservoir Drive, Washington DC, 20007
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  • Hosai N. Hesham MD,

    1. Department of Otolaryngology—Head and Neck Surgery , Veteran's Affairs Hospital, Washington, DC, U.S.A.
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  • Benjamin J. Wycherly MD,

    1. Department of Otolaryngology—Head and Neck Surgery , Georgetown University Hospital, Washington, DC, U.S.A.
    Current affiliation:
    1. Silverstein Otology Institute, 1901 Floyd St., Sarasota, FL 34239
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  • Kevin M. Burke MD,

    1. Department Otolaryngology—Head and Neck Surgery ; University of California, San Francisco, San Francisco, California, U.S.A.
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  • Sonya Malekzadeh MD

    Corresponding author
    1. Department of Otolaryngology—Head and Neck Surgery , Veteran's Affairs Hospital, Washington, DC, U.S.A.
    • Department of Otolaryngology—Head and Neck Surgery, Georgetown University, Gorman 1 3800 S. Reservoir Rd. NW, Washington, DC 20007
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  • This study was performed in accordance with the PHS Policy on Humane Care and Use of Laboratory Animals, the NIH Guide for the Care and Use of Laboratory Animals, and the Animal Welfare Act (7 U.S.C. et seq.); the animal use protocol was approved by the Institutional Animal Care and Use Committee (IACUC) of Georgetown University.

  • The authors have no conflicts of interest to declare.

  • §

    The authors of this article received some financial support for the study from Boston Scientific Corporation in the form of money and equipment. Sterile operating room equipment was also obtained on loan from Georgetown University Hospital. None of the authors have any financial interests to disclose in relation to this work. The authors report no financial involvement in companies or other entities that have an interest in the information in this paper (e.g., grants, advisory boards, employment, consultancies, contracts, honoraria, royalties, expert testimony, partnerships, or stock ownership in medically related fields).

Abstract

Objective:

To evaluate and compare open versus endoscopic methods of inducing tracheal stenosis in the New Zealand white rabbit model.

Study Design:

Prospective randomized control, pilot study.

Subjects and Methods:

Fifteen New Zealand white rabbits were used in the study. Induction of tracheal stenosis was performed through an open incision in 6 rabbits, an endoscopic approach was utilized in 8 rabbits, and 1 rabbit served as the control. The open approach was performed by brushing the tracheal mucosa 10 times through an anterior tracheotomy with a nylon brush. The endoscopic method was acheived using a rigid bronchoscope and at a measured distance below the cricoid cartilage, passing the same nylon brush four times in each of four quadrants. Repeat endoscopies for evaluation of stenosis progression were performed at 2 and 3 weeks on all rabbits.

Results:

In the open group, we observed no stenosis with one mortality as a result of gastroenteritis due to antibiotic use. In the endoscopic group, all animals achieved some degree of stenosis by 14 days, with a mean airway narrowing of 43%. The two deaths in the endoscopic group occurred in the immediate postoperative period secondary to laryngeal edema. The endoscopic procedure was 5 minutes in duration.

Conclusion:

The endoscopic technique is an effective method of achieving circumferential tracheal stenosis in the rabbit model. Advantages include simple instrumentation, an endoscopic approach, potential for decreased costs, and more reliable results. Laryngoscope, 2011

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