Wound‐healing modulation in upper airway stenosis—Myths and facts

Hirshoren, Nir; Eliashar, Ron

doi:10.1002/hed.20925

Cited by 93 publications

(106 citation statements)

References 153 publications

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“…The initial feasibility of the observer was investigated as a means to detect and classify surgically simulated edema in the subglottic airway of rabbits incorporating statistical decision theories. The ROC curve is an extremely useful tool that: (1) can measure image quality, (2) evaluate the performance of decision strategies, and (3) summarize the difficulty of such classification tasks. 13,14 Therefore, it is essential to first extract ROC curves from full-range OCT airway images in vivo.…”

Section: Discussionmentioning

confidence: 99%

“…This process in the subglottic region of airway may lead to stenosis, abnormal narrowing of airway. 1,2 As edema is the first physiologic event that occurs with injury, the early detection of edema in the subglottis may lead to improvement of airway management, early detection of tissue injury, and hence the prevention of stenosis. The gold standard for diagnosing subglottic edema in vivo is surgical endoscopy, but this is limited to the visual inspection of the airway surface or gentle palpation with blunt surgical instruments cantilevered off the surgeon's fingers.…”

Section: Introductionmentioning

confidence: 99%

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Spatiotemporal correlation of optical coherence tomographyin-vivoimages of rabbit airway for the diagnosis of edema

et al. 2015

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Abstract. Detection of an early stage of subglottic edema is vital for airway management and prevention of stenosis, a life-threatening condition in critically ill neonates. As an observer for the task of diagnosing edema in vivo, we investigated spatiotemporal correlation (STC) of full-range optical coherence tomography (OCT) images acquired in the rabbit airway with experimentally simulated edema. Operating the STC observer on OCT images generates STC coefficients as test statistics for the statistical decision task. Resulting from this, the receiver operating characteristic (ROC) curves for the diagnosis of airway edema with full-range OCT in-vivo images were extracted and areas under ROC curves were calculated. These statistically quantified results demonstrated the potential clinical feasibility of the STC method as a means to identify early airway edema. © The Authors. Published by SPIE under a Creative Commons Attribution 3.0 Unported License. Distribution or reproduction of this work in whole or in part requires full attribution of the original publication, including its DOI.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Spatiotemporal correlation of optical coherence tomographyin-vivoimages of rabbit airway for the diagnosis of edema

et al. 2015

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“…The primary and most important complication of surgical treatments is recurrent stenosis related to formation of granulation tissue. 3 Some treatments are used to avoid the formation of granulation tissue and any one of the 3 stages of wound healing 5 : stage 1 (inflammation phase), antibiotics, corticosteroids, and hyperbaric oxygen therapy; stage 2 (proliferation phase), antibiotics, corticosteroids, mitomycin C, combination of 5-fluorouracil and triamcinolone Research was conducted for new treatment methods to prevent granulation formation in patients with tracheal stenosis. In a study conducted using estrogen and progesterone, Liman et al 6 showed that sex hormones prevent massive collagen and fibroblast proliferation in wound healing after tracheal surgery.…”

Section: Discussionmentioning

confidence: 99%

“…5 Although it is not clear some results show that mitomycin C decreases fibroblast proliferation. Also, it is has been shown that mitomycin C slows wound healing during the inflammation and proliferation stages by decreasing basic fibroblast growth factor and TGF-␤1 levels.…”

Section: Discussionmentioning

confidence: 99%

Effect of Locally Applied Transforming Growth Factor Beta3 on Wound Healing and Stenosis Development in Tracheal Surgery

et al. 2013

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BACKGROUND: Tracheal stenosis constitutes one of the most frequently seen problems in thoracic surgery. Although many treatment modalities to prevent fibroblast proliferation, angiogenesis, or inflammation that causes tracheal stenosis have been attempted, an effective method has not yet been found. In this study, a transforming growth factor beta3 (TGF-␤3)/chitosan combination was used for this purpose. METHODS: A slow-release preparation containing a thin layer of TGF-␤3 with a chitosan base was made. Thirty albino Wistar rats were divided into 3 groups. A full-layer vertical incision was made in the anterior side of the trachea of each rat between the second and fifth tracheal rings. The tracheal incision was sutured. Group A was evaluated as the control group. In Group B, a chitosan-based film was placed on the incision line. In Group C, a slow-release TGF-␤3/chitosan-coated substance was placed on the incision line. The rats were killed on day 30, and their tracheas were excised by cutting between the lower edge of the thyroid cartilage and the upper edge of the sixth tracheal ring together with the esophagus. Epithelialization, fibroblast proliferation, angiogenesis, inflammation, and collagen levels were evaluated histopathologically by the same histopathologist. RESULTS: Statistically significant differences were not found among the 3 groups. Cold abscesses were observed at the incision sites in both the TGF-␤/chitosan and chitosan groups. These were thought to have formed due to the chitosan. CONCLUSIONS: As this was the first experiment in the literature to use this type of TGF-␤3 formulation, we intend to change the formulation and perform this study again with a different TGF-␤3/chitosan preparation.

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“…Topical application of mitomycin C (MMC) is an emerging adjuvant therapy for BTS, and its efficacy has been evaluated in animal and clinical studies. In current studies, an amount of 0.4 mg/ml MMC is topically applied directly to the tracheal mucosa for 2-5min [4]; however, the efficacy and effective concentration of MMC in clinics is still under debate.…”

Section: Introductionmentioning

confidence: 99%

Inhibitory Effect of Mitomycin C on Proliferation of Primary Cultured Fibroblasts from Human Airway Granulation Tissues

Chen

Zhang

et al. 2013

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Background: Airway granulation tissue and scar formation pose a challenge because of the high incidence of recurrence after treatment. As an emerging treatment modality, topical application of mitomycin C has potential value in delaying the recurrence of airway obstruction. Several animal and clinical studies have already proven its feasibility and efficacy. However, the ideal dosage has still not been determined. Objectives: To establish a novel method for culturing primary fibroblasts isolated from human airway granulation tissue, and to investigate the dose-effect of mitomycin C on the fibroblast proliferation in vitro, so as to provide an experimental reference for clinical practitioners. Methods: Granulation tissues were collected during the routine bronchoscopy at our department. The primary fibroblasts were obtained by culturing the explanted tissues. The cells were treated with different concentrations of mitomycin C (0.1, 0.2, 0.4, 0.8 and 1.6 mg/ml) for 5 min followed by additional 48-hour culture before an MTT assay was performed to measure cell viability. Results: MTT assay showed that mitomycin C reduced cell viability at all tested concentrations. The inhibitory ratios were 10.26, 26.77, 32.88, 64.91 and 80.45% for cells treated with mitomycin C at 0.1, 0.2, 0.4, 0.8 and 1.6 mg/ml, respectively. Conclusions: Explant culture is a reliable method for culturing primary fibroblasts from human airway granulation tissue, and mitomycin C can inhibit proliferation of the fibroblasts in vitro.

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Wound‐healing modulation in upper airway stenosis—Myths and facts

Cited by 93 publications

References 153 publications

Spatiotemporal correlation of optical coherence tomographyin-vivoimages of rabbit airway for the diagnosis of edema

Spatiotemporal correlation of optical coherence tomographyin-vivoimages of rabbit airway for the diagnosis of edema

Effect of Locally Applied Transforming Growth Factor Beta3 on Wound Healing and Stenosis Development in Tracheal Surgery

Inhibitory Effect of Mitomycin C on Proliferation of Primary Cultured Fibroblasts from Human Airway Granulation Tissues

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