A Tissue-Engineering Technique for Vascularized Laryngotracheal Reconstruction

Glatz, Frank R.; Neumeister, Michael W.; Suchy, Hans; Lyons, Sharon; Damikas, Dimitri; Mowlavi, Arian

doi:10.1001/archotol.129.2.201

Cited by 21 publications

(18 citation statements)

References 22 publications

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“…The reasons for using the rabbit as a model are diverse, and many of the articles comment on its suitability as a simulation tool. The laryngotracheal size of an adult rabbit is considered to approximate that of the neonate in several articles . Foggia et al quantified this in their study, describing a mean cricoid cross‐sectional area of 15.7 mm 2 in adult rabbits .…”

Section: Resultsmentioning

confidence: 99%

“…As all the studies utilized rabbits for in vivo experiments, several articles also highlight positive aspects of the rabbit model that only apply to the use of live rabbits. Experimental rabbits demonstrated good airway healing, limiting perioperative mortality and allowing long‐term assessment of laryngotracheal growth . In addition, subglottic stenosis can be induced in the rabbit following subglottic trauma …”

Section: Resultsmentioning

confidence: 99%

“…Conversely, several articles highlighted negative aspects of using the rabbit model. The laryngotracheal size was considered only to approximate to very small neonates, and was therefore unsuitable for older infants . Anatomical variances significantly affected the ability to perform LTR.…”

Section: Resultsmentioning

confidence: 99%

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A systematic review of simulated laryngotracheal reconstruction animal models

et al. 2018

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Objectives Review of the literature to identify practical, high‐fidelity, commercially available animal models for simulation training and surgical skills maintenance in laryngotracheal reconstruction (LTR). Methods A systematic review of PubMed and Embase databases was conducted independently by two authors, according to Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. Search terms included “laryngotracheal reconstruction,” “laryngotracheoplasty,” “pig and larynx,” “sheep and larynx,” and “rabbit and larynx.” Articles were then assessed, identifying model cost and availability, model validation, feasibility as a training tool, and verisimilitude to pediatric LTR. Results In total, 79 articles were considered suitable for inclusion in the study, incorporating both in vitro and in vivo models. Models utilized included rabbit (n = 69), pig (n = 7), sheep (n = 1), and goat (n = 2). The rabbit model was similar in size to the neonate, but differences in laryngeal anatomy and cartilage texture made graft insertion difficult. The anatomy of the pig, sheep, and goat larynges more closely resembled the pediatric patient, allowing improved grafting, but corresponded more in size to that of an older child. Commercial availability of the pig and sheep was considered greatest, and was reflected in cost. None of the animal models identified in the literature have been validated as a simulation tool. Conclusions The rabbit, sheep and pig models seemed to demonstrate the greatest potential for use as advanced pediatric airway surgery simulation models, with the rabbit model being most utilized in the literature. However, as yet there have been no models formally validated as a simulation training tool. Laryngoscope, 129:235–243, 2019

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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A systematic review of simulated laryngotracheal reconstruction animal models

et al. 2018

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“…In all these oropharyngeal reconstructions the amount of functional deficit is related both to the extent of resection and also to individual patient characteristics and their abilities to cope with the deficits. Portions of the laryngeal wall can be reconstructed with free tissue transfers and in some cases sophisticated total laryngeal reconstructions have been described [19,20]. It is still impossible, however, to restore critical laryngeal function such as vocal cord mobility and protective sensation.…”

Section: The Oropharyngeal Cavitymentioning

confidence: 99%

Frontiers in free flap reconstruction in the head and neck

Cordeiro

2008

Journal of Surgical Oncology

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This chapter describes the state of the art in head and neck free flap reconstruction and will stress some of its major deficits. It will also discuss some of the most promising frontiers in reconstruction, including tissue engineering and composite allotransplantation. The true frontiers of reconstruction need to be refined at the cellular level where tissue engineered from the individual cells and manipulation of the patient's immune system will potentially allow allotransplantation without affecting rates of cancer cure.

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“…The procedures commonly utilized can be categorized into four groups: complete resection and termino-terminal anastomosis of the trachea, resection of the scar tissue with or without coating of the open area, incision in the stenotic site and expansion of the anterior and/or posterior wall with placement of free or pedicled grafts, and pure and simple tracheal dilation [4][5][6] . All approaches have their own degrees of success and failure, but evidence points that the formation of an exuberant layer of granulation tissue on the site of treatment is one of the main reasons of failure due to restenosis [7][8][9][10][11][12] . One of the ways to prevent such tissue from growing is adopting infection preventive measures, using grafts to replace epithelium, and placing molds 2 .…”

Section: Introductionmentioning

confidence: 99%

Avaliação da resposta inflamatória traqueal ao curativo de celulose bacteriana após escarificação cirúrgica em coelhos

Panerari¹,

Costa²,

Souza

et al. 2008

Rev. Bras. Otorrinolaringol.

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Dentre as causas de insucesso nas cirurgias para a estenose traqueal está a formação de tecidos de cicatrização exuberantes. O uso de curativos para evitar esta reação pode ser de grande valia nestes casos. A celulose bacteriana produzida por acetobacter xylinun pode ser útil nestes casos. Não há estudos na região laringotraqueal. OBJETIVO: Avaliar a resposta tecidual subglótica de coelhos após escarificação e colocação de curativo de celulose, comparando com grupo controle. FORMA DE ESTUDO: Experimental MATERIAL E MÉTODOS: Foram estudados 26 coelhos, submetidos a escarificação da região laringotraqueal e tratados com curativo e comparados com controle. Foram estabelecidos 4 tempos de seguimento. Os seguimentos laringotraqueais foram examinados histologicamente e os resultados foram avaliados estaticamente. RESULTADOS: O grupo de estudo evoluiu com o passar do tempo com resultados estatisticamente semelhantes ao do grupo controle, nos parâmetros Congestão vascular, Exsudato purulento, Inflamação aguda, Integridade do epitélio, Proliferação fibrosa e Reação granulomatosa. CONCLUSÃO: Não foram observadas diferenças entre os grupos controle e de estudo quanto aos parâmetros inflamatórios ou cicatriciais. Não houve sinais inflamatórios relacionados ao uso da membrana de celulose que não tivessem ocorrido devido ao traumatismo cirúrgico.

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A Tissue-Engineering Technique for Vascularized Laryngotracheal Reconstruction

Abstract: A pedicled neotracheal graft can be used for anterior cricoid split procedures in rabbits.

Cited by 21 publications

References 22 publications

A systematic review of simulated laryngotracheal reconstruction animal models

A systematic review of simulated laryngotracheal reconstruction animal models

Frontiers in free flap reconstruction in the head and neck

Avaliação da resposta inflamatória traqueal ao curativo de celulose bacteriana após escarificação cirúrgica em coelhos

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