title: Regeneration of Vocal Fold Mucosa Using Tissue-Engineered Structures with Oral Mucosal Cells.
abstract: OBJECTIVE
  Scarred vocal folds result in irregular vibrations during phonation due to stiffness of the vocal fold mucosa. To date, a completely satisfactory corrective procedure has yet to be achieved. We hypothesize that a potential treatment option for this disease is to replace scarred vocal folds with organotypic mucosa. The purpose of this study is to regenerate vocal fold mucosa using a tissue-engineered structure with autologous oral mucosal cells.
  
  
  METHODS
  Animal experiment using eight beagles (including three controls).
  
  
  METHODS
  A 3 mm by 3 mm specimen of canine oral mucosa was surgically excised and divided into epithelial and subepithelial tissues. Epithelial cells and fibroblasts were isolated and cultured separately. The proliferated epithelial cells were co-cultured on oriented collagen gels containing the proliferated fibroblasts for an additional two weeks. The organotypic cultured tissues were transplanted to the mucosa-deficient vocal folds. Two months after transplantation, vocal fold vibrations and morphological characteristics were observed.
  
  
  RESULTS
  A tissue-engineered vocal fold mucosa, consisting of stratified epithelium and lamina propria, was successfully fabricated to closely resemble the normal layered vocal fold mucosa. Laryngeal stroboscopy revealed regular but slightly small mucosal waves at the transplanted site. Immunohistochemically, stratified epithelium expressed cytokeratin, and the distributed cells in the lamina propria expressed vimentin. Elastic Van Gieson staining revealed a decreased number of elastic fibers in the lamina propria of the transplanted site.
  
  
  CONCLUSIONS
  The fabricated mucosa with autologous oral mucosal cells successfully restored the vocal fold mucosa. This reconstruction technique could offer substantial clinical advantages for treating intractable diseases such as scarring of the vocal folds.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
authors.forename: Mioko
authors.initials: M
authors.lastname: Fukahori
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
authors.forename: Shun-Ichi
authors.initials: S
authors.lastname: Chitose
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
authors.forename: Kiminori
authors.initials: K
authors.lastname: Sato
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
authors.forename: Shintaro
authors.initials: S
authors.lastname: Sueyoshi
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kurita
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
authors.forename: Hirohito
authors.initials: H
authors.lastname: Umeno
authors.affiliation: Department of Ophthalmology, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
authors.forename: Yu
authors.initials: Y
authors.lastname: Monden
authors.affiliation: Department of Ophthalmology, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
authors.forename: Ryoji
authors.initials: R
authors.lastname: Yamakawa
mesh_terms: D016475:3T3 Cells; D000818:Animals; D049109:Cell Proliferation; D002478:Cells, Cultured; D018920:Coculture Techniques; D004285:Dogs; D004847:Epithelial Cells / Q000166:cytology; D005260:Female; D005347:Fibroblasts / Q000166:cytology; D006801:Humans; D007820:Laryngeal Mucosa / Q000166:cytology* / Q000637:transplantation / Q000648:ultrastructure; D007828:Laryngoscopy; D051379:Mice; D008855:Microscopy, Electron, Scanning; D023421:Models, Animal; D010699:Phonation / Q000502:physiology; D012038:Regeneration / Q000502:physiology*; D013997:Time Factors; D023822:Tissue Engineering / Q000379:methods*; D016378:Tissue Transplantation / Q000379:methods; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014827:Vocal Cords / Q000502:physiology* / Q000601:surgery