title: MERS versus Standard Surgical Approaches for Porcine Vocal Fold Scarring with Adipose Stem Cell Constructs.
abstract: Cells, scaffold, and surgical approaches are important for regeneration of the lamina propria of the scarred vocal fold (VF). Microendoscopy of Reinke's space (MERS) is a surgical approach used to access the lamina propria. The present study evaluated MERS in the treatment of VF scarring as compared with standardized approaches for the treatment of VF scarring with adipose stem cell constructs.
  
  
  
  Animal study.
  
  
  
  Academic center.
  
  
  
  VF injury was performed bilaterally to induce scarring in 20 pigs. Eight weeks after injury, pigs were classified into no treatment, minithyrotomy, VF injection, VF incision/dissection, and MERS. All groups (except control) were implanted with adipose stem cell and hyaluronan. Four weeks after treatment, histology for collagen, hyaluronan, and fibronectin; mRNA expression for α-smooth muscle actin, tumor growth factor β1, collagen 1α1, collagen 3α1, matrix metalloproteinase 2, basic fibroblast growth factor, and hepatocyte growth factor; and tissue rheology were evaluated.
  
  
  
  Differences were measured among surgical approaches for protein levels of collagen, hyaluronan, and fibronectin (P = .0133, P < .0001, and P = .0025, respectively). Fibroblast growth factor, collagen 1α1, and matrix metalloproteinase 2 transcript levels were different among treatment groups (P = .003, P = .0086, and P = .014, respectively), while no differences were measured for α-smooth muscle actin, tumor growth factor β1, hepatocyte growth factor, and collagen 3α1. Rheologically, significant differences were not measured between groups.
  
  
  
  MERS is a promising surgical approach for the treatment of VF scarring, optimizing the placement of implanted biomaterials.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Gil Medical Center, Gachon University, Incheon, Korea.
authors.forename: Joo Hyun
authors.initials: JH
authors.lastname: Woo
authors.affiliation: Department of Neurological Surgery, University of Louisville, Louisville, Kentucky, USA.
authors.forename: Suzanne N
authors.initials: SN
authors.lastname: King
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City, Iowa, USA.
authors.forename: Henry
authors.initials: H
authors.lastname: Hoffman
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Wisconsin-Madison, Madison, Wisconsin, USA.
authors.forename: Seth
authors.initials: S
authors.lastname: Dailey
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Wisconsin-Madison, Madison, Wisconsin, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Wang
authors.affiliation: National Center for Voice and Speech, University of Utah, Salt Lake City, Utah, USA.
authors.forename: Michael B
authors.initials: MB
authors.lastname: Christensen
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Wisconsin-Madison, Madison, Wisconsin, USA thibeaul@surgery.wisc.edu.
authors.forename: Susan L
authors.initials: SL
authors.lastname: Thibeault
mesh_terms: D000818:Animals; D015415:Biomarkers / Q000032:analysis; D002478:Cells, Cultured; D002921:Cicatrix / Q000473:pathology* / Q000601:surgery*; D004195:Disease Models, Animal; D005260:Female; D015718:Fibrin Tissue Adhesive; D020100:Hydrogels / Q000008:administration & dosage / Q000494:pharmacology; D007124:Immunoenzyme Techniques; D007828:Laryngoscopy; D060888:Real-Time Polymerase Chain Reaction; D033581:Stem Cell Transplantation; D013552:Swine; D014827:Vocal Cords / Q000473:pathology* / Q000601:surgery*
chemical_list: D015415:Biomarkers; D015718:Fibrin Tissue Adhesive; D020100:Hydrogels
keywords: Reinke’s space; adipose tissue–derived stromal cells; hydrogel; scar; vocal fold