Airway reconstruction with carrier-free cell sheets composed of autologous nasal squamous epithelium.
OBJECTIVE
Although skin has been the most effective graft material for reconstructing the airway lumen, the use of squamous epithelium has many problems. If autologous airway squamous epithelium could differentiate into mucociliary epithelium after in vivo grafting, it could be an answer to these problems. In this study, we wanted to examine whether carrier-free nasal epithelial cell sheets composed of autologous squamous epithelium could be used as a substitute for skin in airway luminal reconstruction in three maxillectomy patients.


METHODS
In vitro biochemical experiments with in vivo applications.


METHODS
We cultured nasal squamous epithelium from three maxillary cancer patients prior to maxillectomy. These squamous cell sheets were grafted on the forearm free flap, and, after maxillectomy, the surgical defect was reconstructed with a prefabricated myocutaneous radial forearm free flap with the cultured nasal squamous epithelium. At 1 and 3 month intervals after the reconstructive surgery, the cultured cell grafted area was investigated with histologic phenotype, comparing the skin grafted area.


RESULTS
The autologous nasal squamous epithelial cell sheet differentiated into mucociliary epithelium without the crust or mucus stagnation that is usually observed in cases in which skin graft is used for airway reconstruction.


CONCLUSIONS
We suggest that autologous cultured nasal squamous epithelium, which differentiates into mucociliary epithelium after in vivo grafting, can be used as a clinically relevant substitute for skin graft in airway luminal reconstruction.
Koo
Jaseok P
JP
Department of Thoracic/Head and Neck Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Kim
Chang-Hoon
CH
Lee
Jeung-Gweon
JG
Kim
Kyung-Su
KS
Yoon
Joo-Heon
JH
D002478:Cells, Cultured; D055233:Cornified Envelope Proline-Rich Proteins; D005819:Genetic Markers; D006579:Heterozygote; D006801:Humans; D008441:Maxillary Neoplasms / Q000235:genetics / Q000601:surgery* / Q000628:therapy; D008565:Membrane Proteins / Q000235:genetics / Q000378:metabolism; D055271:Mucin 5AC; D009077:Mucins / Q000235:genetics / Q000378:metabolism; D009297:Nasal Mucosa / Q000166:cytology* / Q000378:metabolism; D010256:Paranasal Sinuses / Q000166:cytology* / Q000378:metabolism*; D010641:Phenotype; D012333:RNA, Messenger / Q000235:genetics; D019651:Plastic Surgery Procedures / Q000379:methods*; D020133:Reverse Transcriptase Polymerase Chain Reaction; D016038:Skin Transplantation; D013524:Surgical Flaps; D014182:Transplantation, Autologous
D055233:Cornified Envelope Proline-Rich Proteins; D005819:Genetic Markers; C524678:MUC5AC protein, human; C105059:MUC8 protein, human; D008565:Membrane Proteins; D055271:Mucin 5AC; D009077:Mucins; D012333:RNA, Messenger