Hyaluronan-Based Scaffolds to Tissue-Engineer Cartilage Implants for Laryngotracheal Reconstruction

High prevalence of osteoarthritis and poor intrinsic healing capacity of articular cartilage create a demand for cell-based strategies for cartilage repair. It is possible to tissue engineer cartilage with almost native proteoglycan content, but collagen reaches only 15% to 35% of the native content. Also its natural structural organization is not reproduced. These drawbacks contribute to its insufficient load-bearing properties.

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Mechanical Stimulation Enhances Collagen Synthesis in Periosteum-Derived Cartilage

ASME 2009 Summer Bioengineering Conference, Parts A and B ◽

10.1115/sbc2009-204245 ◽

2009 ◽

Cited By ~ 1

Author(s):

Agnese Ravetto ◽

Linda M. Kock ◽

Corrinus C. van Donkelaar ◽

Keita Ito

Keyword(s):

Mechanical Properties ◽

Articular Cartilage ◽

Mechanical Loading ◽

Cartilage Repair ◽

Structural Organization ◽

Collagen Synthesis ◽

Engineer Cartilage ◽

High Prevalence ◽

Proteoglycan Content ◽

Tissue Engineer Cartilage

High prevalence of osteoarthritis and poor intrinsic healing capacity of articular cartilage create a demand for cell-based strategies for cartilage repair. It is possible to tissue engineer cartilage with almost native proteoglycan content, but collagen reaches only 15% to 35% of the native content. Also its natural arcade-like structural organization is not reproduced. These drawbacks contribute to its insufficient load-bearing properties. It is generally believed that the application of mechanical loading during culturing will improve the mechanical properties. However, a suitable mechanical loading regime has not yet been established.

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Faculty Opinions recommendation of Single-stage laryngotracheal reconstruction using bioabsorbable miniplates.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.4685956.4631054 ◽

2010 ◽

Author(s):

Nico Jonas ◽

Hasnaa Ismail-Koch

Keyword(s):

Single Stage ◽

Laryngotracheal Reconstruction

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Tracheocutaneous Fistula After Pediatric Open Airway Reconstruction

Annals of Otology Rhinology & Laryngology ◽

10.1177/0003489420987426 ◽

2021 ◽

pp. 000348942098742

Author(s):

Stephen R. Chorney ◽

Joanne Stow ◽

Luv R. Javia ◽

Karen B. Zur ◽

Ian N. Jacobs ◽

...

Keyword(s):

Costal Cartilage ◽

Case Series ◽

Primary Objective ◽

Multivariable Logistic Regression Analysis ◽

Pediatric Airway ◽

Surgical Closure ◽

Laryngotracheal Reconstruction ◽

Airway Reconstruction ◽

Tracheocutaneous Fistula

Objectives: Tracheocutaneous fistula (TCF) is a common occurrence after pediatric tracheostomy decannulation. However, the persistence of TCF after staged reconstruction of the pediatric airway is not well-described. The primary objective was to determine the rate of persistent TCF after successful decannulation in children with staged open airway reconstruction. Methods: A case series with chart review of children who underwent decannulation after double-stage laryngotracheal reconstruction between 2017 and 2019. Results: A total of 26 children were included. The most common open airway procedure was anterior and posterior costal cartilage grafting (84.6%, 22/26). Median age at decannulation was 3.4 years (IQR: 2.8-4.3) and occurred 7.0 months (IQR: 4.3-10.4) after airway reconstruction. TCF persisted in 84.6% (22/26) of children while 15.4% (4/26) of stomas closed spontaneously. All closures were identified by the one-month follow-up visit. There was no difference in age at tracheostomy ( P = .86), age at decannulation ( P = .97), duration of tracheostomy ( P = .43), or gestational age ( P = .23) between stomas that persisted or closed. Median diameter of stent used at reconstruction was larger in TCFs that persisted (7.0 mm vs 6.5 mm, P = .03). Tracheostomy tube diameter ( P = .02) and stent size ( P < .01) correlated with persistence of TCF on multivariable logistic regression analysis. There were 16 surgical closure procedures, which occurred at a median of 14.4 months (IQR: 11.4-15.4) after decannulation. Techniques included 56.3% (9/16) by primary closure, 18.8% (3/16) by secondary intention and 25% (4/16) by cartilage tracheoplasty. The overall success of closure was 93.8% (15/16) at latest follow-up. Conclusions: Persistent TCF occurs in 85% of children who are successfully decannulated after staged open airway reconstruction. Spontaneous closure could be identified by 1 month after decannulation and was more likely when smaller stents and tracheostomy tubes were utilized. Surgeons should counsel families on the frequency of TCF and the potential for additional procedures needed for closure.

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