Effectiveness of Palatal Mucosa Graft in Surgical Treatment of Sub-Glottic Stenosis

Abstract

ObjectivesMucosal free grafts may be successfully applied in many surgical interventions. This study aims at investigating the feasibility of palatal mucosa graft in sub-glottic field in an animal model.MethodsThis randomized prospective controlled study was conducted with an animal model. Sub-glottic inflammation was created in 15 adult rabbits in each group and sub-glottic stenosis surgery was applied thereafter. The rabbits in group 1 (control group) underwent segmental resection, partial cricoidectomy, and trachea-thyroid cartilage anastomosis; the rabbits in group 2 underwent segmental resection, cricoplasty, and crico-tracheal anastomosis using free buccal mucosa graft; and the rabbits in group 3 underwent segmental resection, cricoplasty, and crico-tracheal anastomosis using free palatal mucosa graft. Re-stenosis was evaluated after 42 days.ResultsThe percentages of stenosis were 27%±20%, 40%±20%, and 34%±23% for group 1, 2, and 3, respectively and the difference was not statistically significant (P=0.29). Intensive and tight fibrosis was observed in 2 rabbits (13%) in group 1, in 5 rabbits (33%) in group 2, and in 3 rabbits (20%) in group 3. There was not a statistically significant difference between groups (P=0.41). Excessive inflammation was observed in 3 rabbits (20%) in group 1, in 7 rabbits (47%) in group 2, and 3 rabbits (20%) in group 3. There was no a statistically significant difference between groups although inflammation rate was higher in the rabbits which underwent buccal mucosa graft (P=0.18).ConclusionThe surgical treatments applied with free mucosa graft reduced anastomosis tension through enabling anastomosis to the distal of cricoid instead of thyroid cartilage. Free palatal mucosa grafts may be used in sub-glottic field, one of the most challenging fields of trachea surgery, due to ease of application and rapid vascularization.

RETRACTED ARTICLE: Accelerated oral wound healing using a pre-vascularized mucosal cell sheet

“…Inflammation at the wound site is an important determinant of wound healing processes. An excessively activated inflammatory response might hinder the regeneration process and eventually lead to hypertrophic scar contraction and fibrosis 37 , 38 . The present study demonstrated that autologous mucosal sheet grafting was well adapted and survived in the surgical wound.…”

Use of a pre-vascularised oral mucosal cell sheet for promoting cutaneous burn wound healing

“…Inflammatory reactions at the wound site are an important determinant of healing. The regeneration potential might be hindered by excessive inflammatory responses that eventually result in fibrosis and hypertrophic scar formation 31 , 32 , as supported by the collagen deposition and the presence of myofibroblasts in control wounds in our study. The pre-vascularized mucosal grafts prevented excessive inflammatory responses and granulation formation in the wounds, eventually facilitating a more natural wound healing process 33 .…”

Treatment of intractable oral ulceration with an oral mucosa equivalent

“…Inflammation at wounded sites is an important determinant of the wound healing process. Excessively activated inflammatory responses may hinder the regeneration process and eventually contribute to scar contraction and fibrosis, resulting in remnant scarring and adhesion after wound healing . The present study showed that oral mucosa equivalent grafts adapted well and survived in the bed of repeat major ulcer.…”