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Protection of laryngeal mucosa and function in laryngeal burns by heat absorption of perilaryngeal tissue

  • Laryngology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Objective

The laryngeal tissue carries most of the heat during inhalation injury. This study aims to explore the heat transfer process and the severity of injury inside laryngeal tissue by horizontally studying the temperature rise process at various anatomical layers of the larynx and observing the thermal damage in various parts of the upper respiratory tract.

Methods

The 12 healthy adult beagles were randomly divided into four groups, and inhaled room temperature air (control group), dry hot air of 80 °C (group I), 160 °C (group II), and 320 °C (group III) for 20 min, respectively. The temperature changes of the glottic mucosal surface, the inner surface of the thyroid cartilage, the external surface of the thyroid cartilage, and subcutaneous tissue were measured every minute. All animals were immediately sacrificed after injury, and pathological changes in various parts of laryngeal tissue were observed and evaluated under a microscope.

Results

After inhaling hot air of 80 °C, 160 °C and 320 °C, the increase of laryngeal temperature in each group was ΔT = 3.57 ± 0.25 °C, 7.83 ± 0.15 °C, 11.93 ± 0.21 °C. The tissue temperature was approximately uniformly distributed, and the difference was not statistically significant. The average laryngeal temperature–time curve showed that the laryngeal tissue temperature in group I and group II showed a trend of “first decrease and then increase”, except that the temperature of group III directly increased with time. The prominent pathological changes after thermal burns mainly concluded necrosis of epithelial cells, loss of the mucosal layer, atrophy of submucosal glands, vasodilatation, erythrocytes exudation, and degeneration of chondrocytes. Mild degeneration of cartilage and muscle layers was also observed in mild thermal injury. Pathological scores indicated that the pathological severity of laryngeal burns increased significantly with the increase of temperature, and all layers of laryngeal tissue were seriously damaged by 320 °C hot air.

Conclusions

The high efficiency of tissue heat conduction enabled the larynx to quickly transfer heat to the laryngeal periphery, and the heat-bearing capacity of perilaryngeal tissue has a certain degree of protective effect on laryngeal mucosa and function in mild to moderate inhalation injury. The laryngeal temperature distribution was in accordance with the pathological severity, and the pathological changes of laryngeal burns provided a theoretical basis for the early clinical manifestations and treatment of inhalation injury.

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Funding

This study was supported by the National Natural Science Foundation of China (No. 81071550).

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Authors and Affiliations

  1. Peking University Fourth School of Clinical Medicine, Beijing, 100035, People’s Republic of China

    Zhe Dou

  2. Department of Burns, Beijing Jishuitan Hospital, Xinjiekoudongjie Street 31, Xicheng District, Beijing, 100035, People’s Republic of China

    Zhe Dou, Huihao Jiang, Xiaozhuo Zhao, Chunquan Wen & Guo-An Zhang

  3. Department of Dermatology, The First Hospital of Tsinghua University, Beijing, 100016, People’s Republic of China

    Xiaocheng Zhou

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  1. Zhe Dou
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Correspondence to Guo-An Zhang.

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Dou, Z., Zhou, X., Jiang, H. et al. Protection of laryngeal mucosa and function in laryngeal burns by heat absorption of perilaryngeal tissue. Eur Arch Otorhinolaryngol 280, 4531–4542 (2023). https://doi.org/10.1007/s00405-023-08030-9

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  • DOI: https://doi.org/10.1007/s00405-023-08030-9

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