title: Hyaluronan-based scaffolds to tissue-engineer cartilage implants for laryngotracheal reconstruction.
abstract: OBJECTIVE
  Donor site morbidity, including pneumothorax, can be a considerable problem when harvesting cartilage grafts for laryngotracheal reconstruction (LTR). Tissue-engineered cartilage may offer a solution to this problem. This study investigated the feasibility of using Hyalograft C combined with autologous chondrocytes to tissue engineer cartilage grafts for LTR in rabbits.
  
  
  METHODS
  Animal study.
  
  
  METHODS
  Eighteen New Zealand white rabbits underwent LTR: 12 rabbits received autologous tissue-engineered cartilage grafts and 6 animals, serving as a positive control group, native auricular cartilage. To determine any differences in response to the site of implantation and any potential immune response to the scaffold, a second piece of engineered neocartilage and a non-cell-loaded scaffold were inserted paralaryngeally into a subset of the rabbits. The rabbits were sacrificed 3, 6, 8, 10, and 12 weeks after the LTR and their larynx examined.
  
  
  RESULTS
  None of the 18 rabbits showed signs of respiratory distress. A smooth, noninflammatory scar was visible intraluminally. Histologically, the native auricular cartilage implants showed excellent integration without any signs of inflammation or cartilage degradation. In contrast, all tissue-engineered grafts and empty scaffolds revealed marked signs of an unspecific foreign body reaction, leading to a complete degradation of the neocartilage, whether implanted para- or intralaryngeally.
  
  
  CONCLUSIONS
  In contrast to the success with which Hyalograft C has been applied in articular defect repair, our results indicate that, in rabbits, Hyalograft C initiates a foreign body reaction if implanted intra- or paralaryngeally, leading to cartilage degradation and possible graft failure. These findings suggest limitations on the environment in which Hyalograft C can be applied.
authors: Department of Orthopaedics, Case Western Reserve University, Cleveland, Ohio 44106, USA. m.weidenbecher@gmail.com
authors: Mark
authors: M
authors: Weidenbecher
authors: James H
authors: JH
authors: Henderson
authors: Harvey M
authors: HM
authors: Tucker
authors: Jonathan Z
authors: JZ
authors: Baskin
authors: Amad
authors: A
authors: Awadallah
authors: James E
authors: JE
authors: Dennis
mesh_terms: D000818:Animals; D002356:Cartilage / Q000601:surgery*; D019902:Chondrocytes / Q000378:metabolism*; D004425:Ear Cartilage / Q000166:cytology / Q000637:transplantation*; D004724:Endoscopy; D006820:Hyaluronic Acid / Q000378:metabolism*; D007817:Laryngeal Cartilages / Q000601:surgery*; D008297:Male; D045170:Matrix Attachment Regions; D011817:Rabbits; D019651:Plastic Surgery Procedures / Q000379:methods*; D023822:Tissue Engineering / Q000379:methods*; D014132:Trachea / Q000601:surgery*
chemical_list: D006820:Hyaluronic Acid
references: Biomaterials. 2001 Sep;22(17):2417-24
references: 11511039
references: Laryngoscope. 2001 Nov;111(11 Pt 1):1925-8
references: 11801971
references: Laryngoscope. 1989 Nov;99(11):1111-6
references: 2811550
references: Ann Otol Rhinol Laryngol. 1993 Apr;102(4 Pt 1):247-54
references: 8476164
references: Plast Reconstr Surg. 1997 Aug;100(2):297-302; discussion 303-4
references: 9252594
references: Laryngorhinootologie. 2007 May;86(5):358-64
references: 17226434
references: J Orthop Res. 1999 Mar;17(2):205-13
references: 10221837
references: Clin Orthop Relat Res. 2005 Jun;(435):96-105
references: 15930926
references: J Biomed Mater Res A. 2005 Nov 1;75(2):485-93
references: 16092113
references: Eur J Radiol. 2006 Jan;57(1):3-8
references: 16188418
references: Tissue Eng. 2007 Apr;13(4):843-53
references: 17394383
references: Arch Otolaryngol Head Neck Surg. 1998 Jun;124(6):671-7
references: 9639478