title: Demonstration of the role of an implantable bioscaffold in airway reconstruction: a pilot study utilizing an animal model.
abstract: BACKGROUND
  Laryngotracheal reconstruction is a common procedure to repair subglottic stenosis. Despite a success rate upwards of 85%, this procedure has significant morbidity associated with it, specifically with the site of the graft harvest and recurrence of stenosis. We propose that a recently described cellular bioscaffold xenograft may be useful in reducing these complications.
  
  
  METHODS
  10 Sprague Dawley rats were divided into 2 groups of 5. One group underwent incision through the cricoid and the first two tracheal rings followed by primary closure (G1); the second group underwent incision through the cricoid and the first two tracheal rings followed by placement of the xenograft (G2); additionally, a specimen was harvested from an animal which did not undergo any surgical procedure to compare to the two surgical groups. Specimen harvest occurred on post-operative days 1, 7, 14, 21, and 28.
  
  
  RESULTS
  6 of 10 animals provided usable data. All animals receiving the xenograft survived until the time of specimen harvest. Only 1 animal undergoing primary closure survived beyond post-operative day one. On histology review, the xenograft animals showed a progressive decrease in fibrosis relative to the animals that underwent primary closure. On POD 28, restoration of the respiratory epithelium and intact basement membrane was noted in the xenograft group.
  
  
  CONCLUSIONS
  We believe that this pilot study shows the potential of utilizing bio-implantable biomaterials, specifically a cellular bioscaffold which encourages the ingrowth of native tissue instead of fibrosis. Histologic analysis shows that use of the xenograft can initiate the proliferation of native tissues decreasing the amount of fibrosis present post-operatively, although significant further analysis is needed before definitively concluding that this approach is superior to utilization of a graft.
authors.affiliation: Wayne State University, Department of Otolaryngology, 5E UHC, 4201 St. Antoine, Detroit 48201, MI, USA. Electronic address: asheyn@med.wayne.edu.
authors.forename: Anthony
authors.initials: A
authors.lastname: Sheyn
authors.affiliation: Wayne State University, Department of Otolaryngology, 5E UHC, 4201 St. Antoine, Detroit 48201, MI, USA. Electronic address: rmayerho@med.wayne.edu.
authors.forename: Ross
authors.initials: R
authors.lastname: Mayerhoff
authors.affiliation: Wayne State University, Department of Otolaryngology, 5E UHC, 4201 St. Antoine, Detroit 48201, MI, USA. Electronic address: psvider@gmail.com.
authors.forename: Peter F
authors.initials: PF
authors.lastname: Svider
authors.affiliation: Wayne State University School of Medicine, Department of Pathology, 540 East Canfield Avenue, Detroit, Michigan, 48201. Electronic address: tgiorgad@med.wayne.edu.
authors.forename: Tamar
authors.initials: T
authors.lastname: Giorgadze
authors.affiliation: Wayne State University School of Medicine, Department of Immunology and Microbiology, 540 E. Canfield Avenue, Detroit, MI, 48201. Electronic address: pmontgo@med.wayne.edu.
authors.forename: Paul C
authors.initials: PC
authors.lastname: Montgomery
authors.affiliation: Wayne State University, Department of Otolaryngology, 5E UHC, 4201 St. Antoine, Detroit 48201, MI, USA.
authors.forename: Sean
authors.initials: S
authors.lastname: Mutchnik
authors.affiliation: Wayne State University, Department of Otolaryngology, 5E UHC, 4201 St. Antoine, Detroit 48201, MI, USA. Electronic address: jcoticch@med.wayne.edu.
authors.forename: James
authors.initials: J
authors.lastname: Coticchia
mesh_terms: D000818:Animals; D064593:Heterografts; D007829:Laryngostenosis / Q000601:surgery*; D007830:Larynx / Q000473:pathology / Q000601:surgery*; D008297:Male; D023421:Models, Animal; D010865:Pilot Projects; D019736:Prostheses and Implants; D051381:Rats; D017207:Rats, Sprague-Dawley; D019651:Plastic Surgery Procedures / Q000379:methods*; D054457:Tissue Scaffolds; D014132:Trachea / Q000473:pathology / Q000601:surgery*; D014135:Tracheal Stenosis / Q000601:surgery*
keywords: Bioscaffold; Laryngotracheal reconstruction; Subglottic stenosis