A new concept for reconstruction of atresias of larynx and trachea: lining of wound surfaces with autologous isolated respiratory epithelial cells.
A new method, first applied two years ago in our clinic, has proved to be reliable for achieving a rapid reepithelialisation of epithelial defects after scar removal inside the trachea. The defect is seeded with isolated respiratory epithelial cells harvested the day before from the ethmoid. Isolation of epithelial cells was achieved by keeping the mucosa in 0.25% trypsin buffer solution under room temperature for about 16 h. Afterwards, the epithelial layer was separated from the submucosa using small forceps and knife. Cells were then isolated by pipetting. For seeding the wound the surface was covered with silastic sheeting and the cell suspension then injected into the cleft between both of them. Cell distribution occurred by capillary attraction. The tracheal lumen was maintained by inserting a silastic stent for about three weeks. So far, 10 patients between 6 and 45 years have been treated in this way. In 4 patients the tracheal wall additionally had to be stabilized using rip cartilage. Only in one case above the tracheostoma, considerable scar formation occurred again requiring a second operation some months later. In 8 patients decannulation was meanwhile possible.
Gerhardt
H J
HJ
ENT Clinic, University Hospital (Charité), Humboldt University, Berlin, Germany.
Böhm
K
K
Kaschke
O
O
Biedermann
F
F
D000293:Adolescent; D000328:Adult; D002469:Cell Separation; D002648:Child; D004847:Epithelial Cells; D004848:Epithelium / Q000637:transplantation; D005005:Ethmoid Sinus / Q000166:cytology; D006801:Humans; D007830:Larynx / Q000002:abnormalities / Q000601:surgery*; D008297:Male; D008722:Methods; D008875:Middle Aged; D009092:Mucous Membrane / Q000166:cytology / Q000637:transplantation; D012826:Silicone Elastomers; D014132:Trachea / Q000002:abnormalities / Q000166:cytology / Q000601:surgery*; D014945:Wound Healing
D012826:Silicone Elastomers