Evaluating the Efficacy of Nebulized Ciprofloxacin-Dexamethasone Using a Novel Model of Airway Stenosis

Objective: Acquired airway stenosis lacks effective animal models for evaluating therapeutic interventions. This study aimed to establish a reproducible rabbit model of mixed mucosal and structural stenosis and quantify the therapeutic effects of nebulized ciprofloxacin/dexamethasone in mitigating airway stenosis. Study Design: Controlled experimental animal study. Setting: Preclinical research conducted in a laboratory setting using a rabbit model. Methods: Twenty-eight rabbits underwent open-airway surgery, with a 1-cm longitudinal incision along the anterior of the trachea followed by mucosal abrasion using a nylon brush. Rabbits received nebulized ciprofloxacin/dexamethasone or served as untreated controls. Three weeks post-injury, tracheas were harvested for micro-computed tomography (CT) imaging. Intraluminal and inner tracheal areas were quantified using ImageJ software, and mucosal thickness was calculated. Statistical analysis was performed using GraphPad Prism. Results: Twenty-six rabbits survived and developed significant airway stenosis confined to the injured region, validating model precision and reproducibility. In untreated rabbits, mucosal thickness was significantly greater at the injury site compared to the control site (P <.0001). Compared with untreated rabbits, the treatment group showed significantly reduced mucosal thickness (P =.0016) and a trend towards larger intraluminal area (P =.0571). No significant differences were observed in the inner tracheal area. Conclusion: This novel open surgical model reliably induces mixed mucosal and structural airway stenosis, offering precise control over the injury site. Additionally, this study provides the first quantitative evidence of therapeutic potential for nebulized ciprofloxacin/dexamethasone, demonstrating attenuated mucosal inflammation and airway narrowing, and presents a reproducible model for the preclinical evaluation of airway stenosis treatments.