title: Small Intestinal Submucosa Implantation for the Possible Treatment of Vocal Fold Scar, Sulcus, and Superficial Lamina Propria Atrophy.
abstract: OBJECTIVE
  Evaluate the histologic effects of grafting porcine-derived small intestinal submucosa (SIS) into the vocal fold superficial lamina propria (SLP) layer for the potential treatment of vocal fold scar, sulcus and superficial lamina propria atrophy.
  
  
  METHODS
  Small intestinal submucosa was implanted into the right vocal fold SLP of 6 mongrel dogs. The left vocal fold served as a sham surgical control. At 2, 4, and 6 weeks postoperative, bilateral vocal fold specimens were evaluated histologically.
  
  
  RESULTS
  At 2 and 4 weeks, respectively, SIS-implanted vocal folds demonstrated moderate and mild inflammation and acute and chronic inflammation. At 6 weeks, inflammation was minimal and chronic. The 6-week specimens showed copious amounts of newly generated hyaluronic acid (HA) within the graft. There was no reactive fibrosis at 6 weeks.
  
  
  CONCLUSIONS
  In the canine model, SIS appears safe for SLP grafting. Inflammation is similar to that of sham surgery. Small intestinal submucosa results in newly generated HA without concomitant fibrosis. Small intestinal submucosa has potential to be used in treatment of disorders with SLP, including vocal fold scar, sulcus, and atrophy. Studies evaluating the effect of SIS implantation on vocal fold function, as well as the ultimate fate of the graft, are required.
authors.affiliation: Otolaryngology- HNS, The Voice and Swallowing Institute, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, USA mpitman@nyee.edu.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Pitman
authors.affiliation: Otolaryngology-Head & Neck Surgery, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, USA.
authors.forename: Jonathan A
authors.initials: JA
authors.lastname: Cabin
authors.affiliation: Department of Pathology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, USA.
authors.forename: Codrin E
authors.initials: CE
authors.lastname: Iacob
mesh_terms: D000818:Animals; D001284:Atrophy; D002921:Cicatrix; D004195:Disease Models, Animal; D004285:Dogs; D048091:Guided Tissue Regeneration / Q000379:methods; D007413:Intestinal Mucosa / Q000637:transplantation*; D007421:Intestine, Small / Q000637:transplantation*; D009092:Mucous Membrane / Q000473:pathology*; D013552:Swine; D016378:Tissue Transplantation / Q000379:methods*; D019737:Transplants; D016896:Treatment Outcome; D014827:Vocal Cords / Q000473:pathology / Q000601:surgery; D014832:Voice Disorders / Q000473:pathology / Q000601:surgery*
keywords: benign; laryngology; larynx; otolaryngology; surgical management; vocal fold; voice disorders