title: Effectiveness of Palatal Mucosa Graft in Surgical Treatment of Sub-Glottic Stenosis.
abstract: OBJECTIVE
  Mucosal free grafts may be successfully applied in many surgical interventions. This study aims at investigating the feasibility of palatal mucosa graft in sub-glottic field in an animal model.
  
  
  METHODS
  This randomized prospective controlled study was conducted with an animal model. Sub-glottic inflammation was created in 15 adult rabbits in each group and sub-glottic stenosis surgery was applied thereafter. The rabbits in group 1 (control group) underwent segmental resection, partial cricoidectomy, and trachea-thyroid cartilage anastomosis; the rabbits in group 2 underwent segmental resection, cricoplasty, and crico-tracheal anastomosis using free buccal mucosa graft; and the rabbits in group 3 underwent segmental resection, cricoplasty, and crico-tracheal anastomosis using free palatal mucosa graft. Re-stenosis was evaluated after 42 days.
  
  
  RESULTS
  The percentages of stenosis were 27%±20%, 40%±20%, and 34%±23% for group 1, 2, and 3, respectively and the difference was not statistically significant (P=0.29). Intensive and tight fibrosis was observed in 2 rabbits (13%) in group 1, in 5 rabbits (33%) in group 2, and in 3 rabbits (20%) in group 3. There was not a statistically significant difference between groups (P=0.41). Excessive inflammation was observed in 3 rabbits (20%) in group 1, in 7 rabbits (47%) in group 2, and 3 rabbits (20%) in group 3. There was no a statistically significant difference between groups although inflammation rate was higher in the rabbits which underwent buccal mucosa graft (P=0.18).
  
  
  CONCLUSIONS
  The surgical treatments applied with free mucosa graft reduced anastomosis tension through enabling anastomosis to the distal of cricoid instead of thyroid cartilage. Free palatal mucosa grafts may be used in sub-glottic field, one of the most challenging fields of trachea surgery, due to ease of application and rapid vascularization.
authors.affiliation: Department of Thoracic Surgery, Reconstructive and Aesthetic Surgery, Medical Faculty of Pamukkale University, Denizli, Turkey.
authors.forename: Umit
authors.initials: U
authors.lastname: Aydogmus
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Medical Faculty of Pamukkale University, Denizli, Turkey.
authors.forename: Adem
authors.initials: A
authors.lastname: Topkara
authors.affiliation: Department of Pathology, Medical Faculty of Pamukkale University, Denizli, Turkey.
authors.forename: Metin
authors.initials: M
authors.lastname: Akbulut
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Medical Faculty of Pamukkale University, Denizli, Turkey.
authors.forename: Adem
authors.initials: A
authors.lastname: Ozkan
authors.affiliation: Department of Thoracic Surgery, Reconstructive and Aesthetic Surgery, Medical Faculty of Pamukkale University, Denizli, Turkey.
authors.forename: Figen
authors.initials: F
authors.lastname: Turk
authors.affiliation: Department of Experimental Research Laboratory, Medical Faculty of Pamukkale University, Denizli, Turkey.
authors.forename: Barbaros
authors.initials: B
authors.lastname: Sahin
authors.affiliation: Department of Thoracic Surgery, Liv Hospital, Istanbul, Turkey.
authors.forename: Gokhan
authors.initials: G
authors.lastname: Yuncu
keywords: Airway; Autografts; Mucosal Tissues; Tracheal Stenosis; Wound Healing