RESUMEN
BACKGROUND: Mandibular plates may become exposed following radiation therapy, infection, and mucosal necrosis. This may lead to early removal of the mandibular plates with subsequent instability of bone fragments. OBJECTIVE: To compare fibrin glue, a bioadhesive, with traditional sutures in closing mucosa over exposed mandibular plates in a cat. DESIGN: Prospective matched-pairs analysis. SUBJECTS: Nine cats were used, and each cat served as its own control. INTERVENTION: Bilateral mandibular plates were fixed on the buccal side of the mandible of 9 cats. The surgical defects over the plates were left uncovered. After 4 days, the plates on the right side were covered with a mucosal graft fastened with fibrin glue, and on the left side the grafts were secured with sutures. After 10 days, the grafts were excised and a histological examination was performed. RESULTS: The mean operative time for coverage was 2 minutes 11 seconds for the fibrin glue and 12 minutes 48 seconds for the sutures (P < .001). Gross examination revealed granulation or ulceration in 3 of the fibrin and 9 of the suture specimens (P < .005). All specimens displayed mild-to-moderate acute and chronic inflammation. All sutured specimens showed focal foreign body-type giant cells surrounding fragments of bone and suture. Two mandibular plates were partially exposed on the fibrin glue side. CONCLUSIONS: The use of fibrin glue to cover exposed mandibular plates is safe and well tolerated in cats. Glue application requires a shorter operative time and is associated with fewer occurrences of granulation and ulceration when compared with suture fixation. Further studies are indicated to titrate the concentration of fibrin glue and to prevent plate exposure.
Asunto(s)
Adhesivo de Tejido de Fibrina/uso terapéutico , Prótesis Mandibular/efectos adversos , Piel/lesiones , Adhesivos Tisulares/uso terapéutico , Animales , Placas Óseas/efectos adversos , Gatos , Modelos Animales de Enfermedad , Membrana Mucosa/patología , Membrana Mucosa/cirugía , Procedimientos de Cirugía Plástica/métodos , Rotura/terapia , Técnicas de Sutura , Cicatrización de Heridas/fisiologíaRESUMEN
Eustachian tube dysfunction frequently results in clinical evidence of otitis media with effusion (OME). Surface active substances, surfactants, are hypothesized to play a role in normal eustachian tube function. Recent work in a rodent model has demonstrated improved eustachian tube function with topical application of surfactants to the middle ear. A novel, noninvasive, and clinically practical method of delivering surfactant to the eustachian tube was studied in a gerbil model of OME. Otitis media with effusion was experimentally induced in 20 gerbils by transtympanic inoculation of heat-killed Streptococcus pneumoniae. This represents a well established model for creating a serous effusion in the gerbil that significantly increases eustachian tube opening pressure. Effusion developed in 27 of 40 ears (67.5%) after inoculation. An inhaled nebulized surfactant was used to treat the animals with microscopically confirmed OME in one or both ears. The treatment period was 5 days. Eustachian tube opening studies were performed on both affected and nonaffected animals. Successful eustachian tube opening pressures were obtained in 30 of 36 ears (83.3%). The mean opening pressure for ears without effusion (healthy ears) was 42.8 mmHg. The mean opening pressure for ears with effusion in animals treated with nebulized surfactant was 41.4 mmHg. The difference between these mean values was not statistically significant (t = 0.32; p > 0.50). This pilot study suggests that inhaled nebulized surfactant may be efficacious in treating eustachian tube dysfunction when manifested in disorders such as OME.
Asunto(s)
Otitis Media con Derrame/tratamiento farmacológico , Tensoactivos/uso terapéutico , Administración por Inhalación , Administración Tópica , Aerosoles , Animales , Modelos Animales de Enfermedad , Trompa Auditiva/efectos de los fármacos , Trompa Auditiva/fisiopatología , Ácidos Grasos no Esterificados/administración & dosificación , Ácidos Grasos no Esterificados/uso terapéutico , Gerbillinae , Nebulizadores y Vaporizadores , Otitis Media con Derrame/microbiología , Otitis Media con Derrame/fisiopatología , Fosfatidilcolinas/administración & dosificación , Fosfatidilcolinas/uso terapéutico , Proyectos Piloto , Infecciones Neumocócicas/tratamiento farmacológico , Infecciones Neumocócicas/fisiopatología , Presión , Streptococcus pneumoniae , Tensoactivos/administración & dosificación , Factores de Tiempo , Resultado del Tratamiento , Triglicéridos/administración & dosificación , Triglicéridos/uso terapéuticoRESUMEN
Previous studies on a cryptococcal culture filtrate (CneF) antigen have shown that the antigen is useful in detecting delayed-type hypersensitivity and that it is specific for Cryptococcus. This study further defined one more parameter of specificity, showing that the CneF antigen does not elicit delayed-type hypersensitivity responses in Cryptococcus albidus-sensitized guinea pigs. When the crude CneF antigen was subjected to ultrafiltration fractionation, the skin test active components were found to be in the 50,000 or greater molecular weight range fraction. The concentrated retentates of the XM50 ultrafiltration membrane were more sensitive antigens than the crude CneF antigens. Further fractionation of the XM50 retentate using 3% acrylamide gel electrophoresis separated the antigen into two bands. One band, the P fraction, migrated only a short distance into the gel; the fraction was carbohydrate-like and did not elicit significant skin test responses in sensitized guinea pigs. The other band, G fraction, appeared with the tracking dye, was glycoprotein-like, and elicited significantly positive skin tests in sensitized guinea pigs. G fractions prepared using three different serotypes of Cryptococcus neoformans elicited similar size indurations when used in skin testing guinea pigs sensitized with either the homologous serotype isolated of C. neoformans or the heterologous serotype isolate.