Endoscopic diode laser welding of mucosal grafts on the larynx: a new technique.
Epithelial coverage of a laryngotracheal wound is an important factor in preventing stenosis, and endoscopic transplantation of a free mucosal graft without stents or sutures would be a significant therapeutic advance. In vitro and in vivo canine studies were performed to explore the feasibility of transplantation with a low-power diode laser (400 mW) enhanced by indocyanine green dye-doped albumin. The tensile strength of graft adherence in 10 cadaver larynges was strong (35.25 +/- 10.39 g). Survival studies in live canine models with a specially designed endoscopic instrument set showed excellent healing at 6, 14, and 28 days. Healing was documented with photography and by histologic examination. Successful endoscopic transplantation of a free mucosal graft should improve results of treatment for laryngotracheal stenosis and laryngeal reconstructive surgery.
Department of Otolaryngology-Head and Neck Surgery, Lahey Clinic, Burlington, MA 01805.
Z
Z
Wang
M M
MM
Pankratov
E E
EE
Rebeiz
D F
DF
Perrault
S M
SM
Shapshay
D000418:Albumins; D000818:Animals; D002245:Carbon Dioxide; D002417:Cattle; D004285:Dogs; D004848:Epithelium / Q000473:pathology / Q000503:physiopathology; D004867:Equipment Design; D005240:Feasibility Studies; D006085:Graft Survival; D007208:Indocyanine Green; D007820:Laryngeal Mucosa / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D020704:Laryngoscopes; D007828:Laryngoscopy / Q000379:methods; D007829:Laryngostenosis / Q000601:surgery; D017075:Laser Coagulation / Q000295:instrumentation / Q000379:methods*; D008866:Microsurgery / Q000295:instrumentation / Q000379:methods; D009061:Mouth Mucosa / Q000473:pathology / Q000503:physiopathology / Q000637:transplantation*; D013718:Tensile Strength; D014135:Tracheal Stenosis / Q000601:surgery; D014827:Vocal Cords / Q000601:surgery; D014945:Wound Healing
D000418:Albumins; D002245:Carbon Dioxide; D007208:Indocyanine Green