A tissue-engineering approach for stenosis of the trachea and/or cricoid.
CONCLUSIONS
This new regenerative therapy shows great potential for the treatment of stenosis of the trachea and/or cricoids (STC).


OBJECTIVE
To estimate the potential of tissue-engineered artificial trachea (AT) for treatment of STC in clinical applications. We previously reported that AT was a useful material for implantation into a tracheal defect after resection of cancer. There are many causes of stenosis of the respiratory tract and STC is particularly difficult to treat.


METHODS
The AT was a spiral stent composed of Marlex mesh made of polypropylene and covered with collagen sponge made from porcine skin. Three patients with STC were treated by this tissue-engineering method. All of them suffered from STC caused by long endotracheal intubations. They underwent a two-stage operation. In the first operation, after resection of the stenotic regions, the edge of the tracheal cartilage was sutured to the edge of the skin. The tracheal lumen was exposed and a T-shaped cannula was inserted into the large tracheostoma. At 3 weeks to 2 months after the first operation, the trachea and skin were separated. The trimmed AT with venous blood and basic fibroblast growth factor (b-FGF) was then implanted into the cartilage defect.


RESULTS
Postoperatively, all patients were able to breathe easily and had no discomfort in their daily activities. Six months after the second operation, we observed enough air space in the trachea and cricoid by computed tomography (CT) imaging and fiber endoscopy.
Kanemaru
Shin-ichi
S
Department of Otolaryngology-Head and Neck Surgery, Medical Research Institute, Kitano Hospital, Osaka, Japan.
Hirano
Shigeru
S
Umeda
Hiroo
H
Yamashita
Masaru
M
Suehiro
Atsushi
A
Nakamura
Tatsuo
T
Maetani
Toshiki
T
Omori
Koichi
K
Ito
Juichi
J
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003413:Cricoid Cartilage; D005260:Female; D048091:Guided Tissue Regeneration / Q000379:methods*; D006801:Humans; D007829:Laryngostenosis / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011126:Polypropylenes / Q000627:therapeutic use; D013526:Surgical Mesh; D013536:Suture Techniques; D023822:Tissue Engineering / Q000379:methods*; D054457:Tissue Scaffolds; D014135:Tracheal Stenosis / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome
D011126:Polypropylenes