Evaluation of the effects of glycopyrronium bromide and peru balsam on healing in a pharyngocutaneous fistula model in rats

Purpose: Pharyngocutaneous fistula is the most common early complication after total laryngectomy surgery. It causes prolonged hospital stay, delay of planned radiotherapy and additional morbidities. Although the fistula is closed in 70% of patients with conservative methods, the remaining patients require additional surgical interventions. The aim of this experimental study is to prevent fistula development before pharyngocutaneous fistula occurs. We aimed to reduce the amount of saliva by using glycopyrronium bromide and to increase healing by using peru balsam. Materials and Methods: Thirty-two albino Wistar male rats were distributed equally into 4 groups. In all groups, an incision was made in the upper esophagus and primary suturing was performed. The control group was given only dextrose. The glycopyrronium bromide group was given glycopyrronium bromide and dextrose twice a day. After creating a pharyngotomy, Peru balsam was applied locally and dextrose was administered to the Peru balsam group. Glycopyrronium bromide + peru balsam group; after the pharyngotomy was created, Peru balsam was applied locally and glycopyrronium bromide and dextrose were administered. Rats sacrificed on the 7th day were evaluated macroscopically and histopathologically. (n:30) Results: Although macroscopic healing of pharyngocutaneous fistula was better in the glycopyrronium bromide group, no significant difference was found between the groups in terms of macroscopic healing and erythematous swelling. No significant difference was observed between the groups in terms of inflammatory cell number and angiogenesis. Collagen deposition (p<0.001) and fibroblast density (p<0.0.02) were observed higher in the groups containing glycopyrronium bromide and were found to be statistically significant. Conclusion: In our study, the positive effects of glycopyrronium bromide on macroscopic healing of pharyngocutaneous fistula and fibroblast and collagen formation were shown. More clinical studies are needed to better evaluate the effects of glycopyrronium bromide and peru balsam on pharyngocutaneous fistula healing. Keywords: Animal model, glycopyrronium bromide, pharyngocutaneous fistula, peru balsam