title: Histopathologic changes after tracheobronchial reconstruction with costal cartilage graft for congenital tracheal stenosis.
abstract: OBJECTIVE
  Congenital tracheal stenosis is an uncommon, life-threatening condition. Recently, tracheoplasty using costal cartilage grafts to enlarge the lumen was used successfully in such cases. In this study, we evaluated postoperative changes of costal cartilage grafts after tracheoplasty.
  
  
  METHODS
  Costal cartilage patch tracheoplasty was used for surgical correction of long-segment congenital tracheal stenosis in 18 infants. Six patients whose tracheal specimens were obtained at autopsy are included in this study. The mean age at the time of repair was 4.8 months, and the mean period after operation was 7.5 months. Cartilage graft survival and epithelialization of inner layer was evaluated in each case.
  
  
  RESULTS
  The mean width and length of grafts was 6.3 x 35 mm at operation and 4.0 x 22 mm at autopsy. The graft size was diminished gradually after operation and was replaced completely by mature scar tissue 2 years after operation. However, diameter of the reconstructed site was not reduced. Reepithelialization of the graft site with ciliated columnar epithelium was found in every case. Chondrocyte numbers were reduced and remaining cartilage was rather eosinophilic, suggesting that the degenerative process was ongoing in the graft.
  
  
  CONCLUSIONS
  The costal cartilage grafts established a functional tracheal lumen, and reepithelialization with ciliated columnar epithelium was found at the graft site. The costal cartilage grafts continues to be an important option as graft material for tracheal reconstruction in infants with long segment congenital tracheal stenosis.
authors.affiliation: Department of Pediatric Surgery, Osaka University Medical School, Suita, Osaka, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Oue
authors.forename: S
authors.initials: S
authors.lastname: Kamata
authors.forename: N
authors.initials: N
authors.lastname: Usui
authors.forename: H
authors.initials: H
authors.lastname: Okuyama
authors.forename: K
authors.initials: K
authors.lastname: Nose
authors.forename: A
authors.initials: A
authors.lastname: Okada
mesh_terms: D002356:Cartilage / Q000637:transplantation*; D005260:Female; D006085:Graft Survival; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011184:Postoperative Period; D019651:Plastic Surgery Procedures / Q000379:methods*; D012272:Ribs / Q000637:transplantation*; D014132:Trachea / Q000473:pathology; D014135:Tracheal Stenosis / Q000151:congenital* / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome