Abstract
The present study demonstrates regeneration of the laryngeal and tracheal tissue using in situ tissue engineering technique for airway reconstruction. As the tissue scaffold, Marlex mesh reinforced with polypropylene rings covered by a collagen sponge was developed as the tissue scaffold. This scaffold material was implanted into the defect of the larynx and tracheas in beagle dogs. Post-operative endoscopy showed a well-epithelized surface of the subglottis and trachea. Based on the histological evaluations, regeneration of the cilial epithelium over the scaffold and good incorporation of the scaffold material into the host tissue were observed. Based on a mechanical test, the airway framework was firmly supported by the regenerated tissue. From the successful results of the experimental animal studies, the current regenerative technique was used to repair the trachea of a 78-year-old female patient with thyroid cancer. The right half of the three rings of the trachea was resected and the scaffold material was sutured to the defect. Epithelization continued to cover the artificial material completely for ten months without any complications. The current regenerative technique avoided tracheotomy, a second operation and cervical deformity. Although long-term observation is required, regenerative medicine of the tracheal tissue appears feasible to use for airway reconstruction.
