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When conservative therapies are not eff ective in treating sinus infections, alternate steps can be taken to improve paranasal cavity ventilation. Th ese measures may include surgical procedures such as intranasal endoscopic or maxillary sinus fenestration, and other procedures such as placement of a maxillary sinus tube or a YAMIK sinus catheter. We conducted a prospective study of 25 patients to investigate the eff ects on the nasal mucosa of improved ventilation between the nasal and paranasal cavities. We accomplished this by comparing (1) the results of simultaneously measured nasal cavity and intramaxillary sinus pressures before and aft er widening of ventilation openings, (2) changes in mucociliary transport function as measured by the saccharin test, and (3) changes in nasal airway resistance. Just as multiple transit routes between the nasal cavity and maxillary sinus give rise to greater fl uctuations in intramaxillary sinus pressure, and just as rapid breathing gives rise to even greater pressure fl uctuations than does quiet breathing, we believe that both intranasal cavity airfl ow velocity and the number of ventilation openings present have an eff ect on the state of ventilation between the nasal cavity and maxillary sinus. We also suggest that the establishment of maxillary sinus ventilation openings improves mucociliary clearance.

Regenerative Medicine. Two procedures were performed on cadaveric animals, and 2 survival surgeries were performed on live animals. Our technique combined a segment of fixed, cellfree cadaveric donor trachea and adipose or marrow derived stem cells harvested from the recipient animal. These acellular donor conduits were seeded with host stem cells and implanted.Results: Tracheal reconstruction for tracheal stenosis is an evolving field. Recent success using a stem-cell based engineered trachea required a prolonged incubation ex vivo in a novel "bioreactor." Taking this idea a step further, a single-stage method would be optimal. After completion of both cadaveric surgeries, the surgical procedure was optimized. The following 2 liveanimal procedures were successful demonstrations of the ability to suspend stem cells in fibrin glue, seed the conduit, and replace a segment of trachea. Although both animals were euthanized following completion according to approved IACUC protocol, the final animal was extubated prior to euthanasia, and demonstrated comfortable, spontaneous respiration. Conclusion:Based on pilot study technical success of short segment tracheal replacement with the use of fixed donor trachea and stem cell support, additional animal studies with extended follow-up will provide the necessary data to improve tracheal reconstruction in a single-stage surgical model.