MRI Study of Jellyfish Collagen, Hyaluronic Acid, and Cadaveric Dermis for Injection Laryngoplasty

Laryngoscope. 2021 Aug;131(8):E2452-E2460. doi: 10.1002/lary.29501. Epub 2021 Apr 13.

Abstract

Objectives/hypothesis: Test a new jellyfish collagen biomaterial aimed to increase duration of injection medialization laryngoplasty (IL) against two products in clinical practice.

Study design: Animal model.

Methods: Left recurrent laryngeal nerve sectioning and IL were performed in New Zealand White rabbits (N = 6/group). Group 1 received micronized cross-linked jellyfish collagen (MX-JC) and adipose derived stem cells (ADSCs), Group 2, MX-JC alone, Group 3, cross-linked hyaluronic acid (X-HA), and Group 4, micronized acellular dermis (MACD). Animals were sacrificed at 4 and 12 weeks. Major outcomes were MRI tissue volumes and histopathology.

Results: After 100 μL IL MRI volumes (means ± STD) at 4 and 12 weeks were: Group 1: 27.2 ± 15.6 and 13.1 ± 5.2 μL, Group 2: 60.8 ± 18 and 27.8 ± 2.47 μL, Group 3: 27.4 ± 12 and 10.6 ± 8 μL, and Group 4: 37.5 ± 11 and 9.85 ± 1 μL. Group 2 volumes were largest and Group 3 were smallest in all comparisons (P < .05). Histologically, low grade inflammatory responses were observed in Group 1, mild histiocytic infiltration in Group 2, widespread muscle fiber loss in Group 3, and plasmocytic infiltration in Group 4.

Conclusions: MX-JC showed the least resorption at 4 and 12 weeks among all groups. T cell inflammatory responses were observed with MX-JC but were reduced by 12 weeks while B cell immune responses, indicative of antibody priming, were predominantly noted with MACD. MX-JC + ADSC showed low grade immunity while the XHA showed greater myocyte loss compared to the other groups.

Level of evidence: NA Laryngoscope, 131:E2452-E2460, 2021.

Keywords: Cymetra®; Injection laryngoplasty; Jellyfish collagen; Restylane®; T-cell response; micronized acellular dermis; plasmocytic immunity; stem cells.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acellular Dermis / adverse effects
  • Animals
  • B-Lymphocytes / immunology
  • Biocompatible Materials / administration & dosage
  • Biocompatible Materials / pharmacology
  • Cadaver
  • Collagen / administration & dosage
  • Collagen / pharmacology*
  • Disease Models, Animal
  • Female
  • Hyaluronic Acid / administration & dosage
  • Hyaluronic Acid / analogs & derivatives*
  • Hyaluronic Acid / pharmacology
  • Immunity / immunology
  • Inflammation / pathology
  • Laryngoplasty / methods*
  • Magnetic Resonance Imaging / methods*
  • Magnetic Resonance Imaging / statistics & numerical data
  • Mesenchymal Stem Cells / pathology
  • Plasma Cells / immunology
  • Practice Patterns, Physicians'
  • Rabbits
  • Recurrent Laryngeal Nerve Injuries / complications
  • Recurrent Laryngeal Nerve Injuries / pathology
  • T-Lymphocytes / pathology
  • Vocal Cord Paralysis / diagnosis
  • Vocal Cord Paralysis / etiology
  • Vocal Cord Paralysis / therapy*

Substances

  • Biocompatible Materials
  • Cymetra
  • Hyaluronic Acid
  • Collagen
  • Restylane