Laryngotracheal reconstruction with porous titanium in rabbits: are vascular carriers and mucosal grafts really necessary?

被引:9
作者
Janssen, Luuk M. [1 ]
van Osch, Gerjo J. V. M. [1 ,2 ]
Li, Jia Ping [3 ,4 ]
Kops, Nicole [2 ]
de Groot, Klaas [3 ]
Feenstra, Louw [1 ]
Hardillo, Jose A. U. [1 ]
机构
[1] Erasmus MC, Dept Otorhinolaryngol, Univ Med Ctr Rotterdam, NL-3000 DR Rotterdam, Netherlands
[2] Erasmus MC, Dept Orthopaed, Univ Med Ctr Rotterdam, NL-3000 DR Rotterdam, Netherlands
[3] Univ Twente, Inst Biomed Technol, NL-3723 MB Bilthoven, Netherlands
[4] PoroGen BV Enschede, Enschede, Netherlands
关键词
porous titanium; mucosal graft; cricotracheal complex; tracheal reconstruction; wound healing; fascia flap; TISSUE-ENGINEERED TRACHEA; CARTILAGE; REPLACEMENT; PROSTHESIS; MODEL;
D O I
10.1002/term.254
中图分类号
Q813 [细胞工程];
学科分类号
摘要
Laryngotracheal reconstruction requires a supportive structure with a mucosal lining, which needs a vascular supply in order to regenerate properly. We investigated the necessity of a vascular carrier and mucosal graft when using porous titanium for laryngotracheal reconstruction. Surgical defects of the laryngotracheal complex in 22 rabbits were reconstructed with: (a) porous titanium implanted on a vascularized fascia combined with a buccal mucosal graft (first stage) before transposing to the neck area (second stage); (b) porous titanium implanted on a vascularized fascia (first stage) combined with a mucosal graft (second stage); (c) porous titanium on a pedicled fascia flap; and (d) porous titanium alone. The grafts were tolerated well. Re-epithelialization occurred in all groups. Normal mucosa with a submucosal layer containing vital cells was noted using the titanium implants. Blood vessels were grown in the pores of the titanium scaffold to supply the overlying mucosa. The scaffold was well integrated in the adjacent tracheal cartilage and surrounding tissues, except in the two cases that showed titanium displacement. Inflammation and granulation formation were seen in most rabbits in groups III and IV, initiated probably by the use of buccal mucosal grafts. Reconstruction of a rabbit's trachea using composites of porous titanium, mucosal grafts and a fascia flap is feasible. Titanium seems to meet the requirements needed for closing a small defect of the tracheal wall and allows for re-epithelialization. For larger defects, a vascular carrier with a mucosal graft is probably indispensable to ensure the process of re-epithelialization. Copyright (C) 2010 John Wiley & Sons, Ltd.
引用
收藏
页码:395 / 403
页数:9
相关论文
共 19 条
[1]   Management of tracheal stenosis with a titanium ring and nasal septal cartilage [J].
Aidonis, A ;
Nikolaou, A ;
Bourikas, Z ;
Aidonis, I .
EUROPEAN ARCHIVES OF OTO-RHINO-LARYNGOLOGY, 2002, 259 (08) :404-408
[2]   Tubes of vascularized cartilage used for replacement of rabbit cervical trachea [J].
Delaere, PR ;
Hardillo, J .
ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY, 2003, 112 (09) :807-812
[3]   Tracheal replacements: Part 2 [J].
Doss, Amy E. ;
Dunn, Sarah S. ;
Kucera, Kristin A. ;
Clemson, Lindsey A. ;
Zwischenberger, Joseph B. .
ASAIO JOURNAL, 2007, 53 (05) :631-639
[4]  
DUFF BE, 1994, LARYNGOSCOPE, V104, P409
[5]   Tracheal replacement: A critical review [J].
Grillo, HC .
ANNALS OF THORACIC SURGERY, 2002, 73 (06) :1995-2004
[6]   Tracheal reconstruction using tissue-engineered cartilage [J].
Grimmer, JF ;
Gunnlaugsson, CB ;
Alsberg, E ;
Murphy, HS ;
Kong, HJ ;
Mooney, DJ ;
Weatherly, RA .
ARCHIVES OF OTOLARYNGOLOGY-HEAD & NECK SURGERY, 2004, 130 (10) :1191-1196
[7]   Laryngotracheoplasty using the Medpor implant: An animal model [J].
Hashem, FK ;
Al Homsi, M ;
Mahasin, ZZ ;
Gammas, MA .
JOURNAL OF OTOLARYNGOLOGY, 2001, 30 (06) :334-339
[8]   HYDROXYLAPATITE FOR LARYNGOTRACHEAL FRAMEWORK RECONSTRUCTION [J].
HIRANO, M ;
YOSHIDA, T ;
SAKAGUCHI, S .
ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY, 1989, 98 (09) :713-717
[9]   Tracheal Reconstruction Mucosal Survival on Porous Titanium [J].
Janssen, Luuk M. ;
van Osch, Gerjo J. V. M. ;
Li, Jia Ping ;
Kops, Nicole ;
de Groot, Klaas ;
Von den Hoff, Johannes W. ;
Feenstra, Louw ;
Hardillo, Jose A. U. .
ARCHIVES OF OTOLARYNGOLOGY-HEAD & NECK SURGERY, 2009, 135 (05) :472-478
[10]   Polyglycolic acid/poly-L-lactic acid copolymer use in laryngotracheal reconstruction: a rabbit model [J].
Klein, AM ;
Graham, VL ;
Gulleth, Y ;
Lafreniere, D .
LARYNGOSCOPE, 2005, 115 (04) :583-587