Decellularized tracheal scaffolds offer a potential solution for the repair of long-segment tracheal defects. However, complete decellularization of trachea is complicated by tracheal collapse. We created a partially decellularized tracheal scaffold (DTS) and characterized regeneration in a mouse model of tracheal transplantation. All cell populations except chondrocytes were eliminated from DTS. DTS maintained graft integrity as well as its predominant extracellular matrix (ECM) proteins. We then assessed the performance of DTS in vivo. Grafts formed a functional epithelium by study endpoint (28 days). While initial chondrocyte viability was low, this was found to improve in vivo. We then used atomic force microscopy to quantify micromechanical properties of DTS, demonstrating that orthotopic implantation and graft regeneration lead to the restoration of native tracheal rigidity. We conclude that DTS preserves the cartilage ECM, supports neo-epithelialization, endothelialization and chondrocyte viability, and can serve as a potential solution for long-segment tracheal defects.

We tested composite tracheal grafts (CTG) composed of a partially decellularized tracheal graft (PDTG) combined with a 3-dimensional (3D)-printed airway splint for use in long-segment airway reconstruction. CTG is designed to recapitulate the 3D extracellular matrix of the trachea with stable mechanical properties imparted from the extraluminal airway splint. We performed segmental orthotopic tracheal replacement in a mouse microsurgical model. MicroCT was used to measure graft patency. Tracheal neotissue formation was quantified histologically. Airflow dynamic properties were analyzed using computational fluid dynamics. We found that CTG are easily implanted and did not result in vascular erosion, tracheal injury, or inflammation. Graft epithelialization and endothelialization were comparable with CTG to control. Tracheal collapse was absent with CTG. Composite tracheal scaffolds combine biocompatible synthetic support with PDTG, supporting the regeneration of host epithelium while maintaining graft structure.

Background Empty nose syndrome ENS is a controversial upper airway disorder most commonly associated with tissue loss from the inferior turbinates The inferior meatus augmentation procedure IMAP has been shown to effectively reduce ENS symptoms in a durable manner but the precise mechanisms that may govern this symptomatic improvement remain unknown Methods Five patients with ENS who underwent bilateral IMAP via submucosal costal cartilage implant were assessed Pre-implant and months post-implant computed tomography CT imaging for each ENS patient was analyzed in a blinded fashion using computational fluid dynamics CFD modeling to investigate intrapatient changes in airflow parameters Results Following surgery ENS patients have significantly improved symptoms as indexed by Empty Nose Syndrome -Item Questionnaire ENS Q scoring pre-implant ± mean ± standard deviation confidence interval CI to post-implant ± CI to Cohen's d = p = Using CFD a significant shi in nasal airflow patterns was observed where airflow deviates away from the middle meatus upon hitting the implant pre-implant ± CI to post-implant ± CI to d = p < toward the inferior meatus pre-implant ± CI to post-implant ± CI to d = p < No significant changes were found in nasal resistance pre-implant ± CI to Pa*s/mL post-implant ± CI toPa*s/mL In addition the improvement of ENS Q scoring significantly correlated with percent reduction in aberrant airflow through the middle meatus R = p = Conclusion This study supports our prior working hypothesis that disordered vectors of nasal airflow congregate in the middle meatus contribute to ENS symptoms not nasal resistance Moreover these data illuminate a paradoxical but consistent restoration of nasal airflow to the inferior meatus following the replacement of turbinate tissue volume in the inferior meatus via IMAP surgery potentially due to the Coandȃ effect © 2020 ARS-AAOA, LLC.