Vocal fold augmentation with injectable polycaprolactone microspheres/pluronic F127 hydrogel: long-term in vivo study for the treatment of glottal insufficiency.
There is increasing demand for reconstruction of glottal insufficiency. Several injection materials have been examined for this purpose, but all had limitations, such as poor long-term durability, migration from the injection site, inflammation, granuloma formation, and interference with vocal fold vibration due to viscoelastic mismatch. Here, we developed a novel injection material, consisting of polycaprolactone (PCL) microspheres, which exhibits better viscoelasticity than conventional materials, and Pluronic F127 carrier, which decreases the migration of the injection materials. The material was injected into rabbits with glottal insufficiency and compared with the FDA-approved injection material, calcium hydroxylapatite (CaHA). Endoscopic and histological examinations indicated that PCL/Pluronic F127 remained at the injection site with no inflammatory response or granuloma formation, whereas CaHA leaked out and migrated from the injection site. Therefore, vocal fold augmentation was almost completely retained during the 12-month follow-up period in this study. Moreover, induced phonation and high-speed recording of vocal fold vibration showed decreased vocal fold gap area in the PCL/Pluronic F127 group. Our newly developed injection material, PCL/Pluronic F127, permits efficient augmentation of paralyzed vocal fold without complications, a concept that can be applied clinically, as demonstrated by the successful long-term follow-up.
Department of Otorhinolaryngology, Head and Neck Surgery, Seoul National University Hospital, Seoul, Republic of Korea ; Cancer Research Institute, Seoul, Republic of Korea ; Seoul National University Medical Research Center, Seoul, Republic of Korea.
Seong Keun
SK
Kwon
Department of Otorhinolaryngology, Head and Neck Surgery, Dongguk University Ilsan Hospital, Goyang, Republic of Korea.
Hee-Bok
HB
Kim
Department of Otorhinolaryngology, Head and Neck Surgery, Dongguk University Ilsan Hospital, Goyang, Republic of Korea.
Jae-Jun
JJ
Song
Department of Otorhinolaryngology, Head and Neck Surgery, Dongguk University Ilsan Hospital, Goyang, Republic of Korea.
Chang Gun
CG
Cho
Department of Otorhinolaryngology, Head and Neck Surgery, Dongguk University Ilsan Hospital, Goyang, Republic of Korea.
Seok-Won
SW
Park
Department of Pathology, Dongguk University Ilsan Hospital, Goyang, Republic of Korea.
Jong-Sun
JS
Choi
Head and Neck Oncology Clinic, National Cancer Center, Goyang, Republic of Korea.
Junsun
J
Ryu
Department of Nanobiomedical Science & WCU Research Center, Dankook University, Cheonan, Republic of Korea.
Se Heang
SH
Oh
Department of Advanced Materials, Hannam University, Yuseong Gu, Daejeon, Republic of Korea.
Jin Ho
JH
Lee
D000818:Animals; D004195:Disease Models, Animal; D005500:Follow-Up Studies; D006801:Humans; D020136:Hydrogel, Polyethylene Glycol Dimethacrylate; D007267:Injections / Q000379:methods; D007828:Laryngoscopy; D008863:Microspheres; D010699:Phonation; D020442:Poloxamer / Q000008:administration & dosage*; D011091:Polyesters / Q000008:administration & dosage*; D019736:Prostheses and Implants; D011817:Rabbits; D013501:Surface-Active Agents / Q000008:administration & dosage; D013997:Time Factors; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000503:physiopathology / Q000601:surgery*; D014827:Vocal Cords / Q000503:physiopathology / Q000601:surgery; D055114:X-Ray Microtomography
D011091:Polyesters; D013501:Surface-Active Agents; D020442:Poloxamer; C016240:polycaprolactone; D020136:Hydrogel, Polyethylene Glycol Dimethacrylate