Tracheal Resection and Mucociliary Clearance

Abstract

Mucociliary transport following tracheal resection and end-to-end anastomosis was evaluated in beagle dogs, using the movement of 99MTC labeled sodium pertechnetate solution as a marker. Preoperatively, mucociliary clearance was stable, but a three-fold decrease in tracheal mucus movement was found three days postoperatively. Clearance rates had returned to normal by 31 days postoperatively and remained stable over a ten week period of observation. By histological examination, normal ciliated epithelium was seen within six months following resection and anastomosis. Since up to 25% (4 cm or seven tracheal rings) of tracheal length was removed, significant longitudinal loss can take place without functional impairment of mucociliary clearance. Circumferential narrowing, however, was associated with a significant decrease in clearance.

A study of the normal temporal healing pattern and the mucociliary transport after endoscopic partial and full‐thickness removal of nasal mucosa in sheep

“…In addition, normal adjacent moving cilia can exert traction on the viscous mucous layer over the wounded epithelium and help the mucociliary transport rate 13 . Giordano and Holsclaw also observed this bridging effect on incompletely re‐epithelialized tracheal anastomosis 14 . The mucociliary transport system can also bypass the healing non‐ciliated epithelium by changing the direction of the transit by changing the viscosity of the mucus 13 .…”

Tracheal Resection and Anastomosis After Traumatic Tracheal Stenosis in a Horse

“…Experimentally, in dogs, a 20% reduction in luminal diameter is reported to reduce mucociliary clearance by up to 65% and ciliated respiratory epithelium covers the tracheal surgical site within 6 months postoperatively. 15 This case demonstrates successful use of a surgical technique of tracheal end-to-end anastomosis in the horse. Whereas postoperative complications occurred, regular postoperative examination allowed the early treatment of these and subsequent return to full athletic work.…”

“…Impaired mucociliary clearance function can occur because of delayed formation of ciliated epithelium at a tracheal anastomosis site or to luminal stenosis. Experimentally, in dogs, a 20% reduction in luminal diameter is reported to reduce mucociliary clearance by up to 65% and ciliated respiratory epithelium covers the tracheal surgical site within 6 months postoperatively …”

Radioaerosol inhalation lung cine-scintigraphy: a preliminary report.

“…aerosol; cine-scintigraphy; inhalation; lung; mucociliary clearance Mucociliary activity can be assessed by sequential measurement of a tracer material placed on the airway whether the tracer be a radioactive droplet (Mann and Morrow 1969;Giordano and Holsclaw 1976;Isawa et al 1980), teflon discs (Sackner et al 1973;Wanner et al 1973;Santz Cruz et al 1974;Landa et al 1975;Friedman et al 1977;Goodman et al 1977), or inhaled radioactive particles (Taplin and Poe 1965;Morrow et al 1967;Isawa et al 1970;Albert et al 1973). Acute exposure to cigarette smoke, for example, could almost lead to ciliostasis in a dosedependent manner in the dog trachea , and no mucociliary clearance was demonstrated in two patients with Kartagener's syndrome (Camner et al 1975).…”

“…Mucociliary clearance has been studied directly by bronchoscopy (Hilding 1957) or cine-bronchofiberscopy (Sackner et al 1973;Wanner et al 1973;Landa et al 1975), or indirectly by radiography (Friedman et al 1977) or external measurement of radioactivity by scintillation detectors including gamma cameras (Mann and Morrow 1969;Isawa et al 1970Isawa et al , 1980Sakakura and Proctor 1972;Yeates et al 1975;Giordano and Holsclaw 1976).…”