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

Umit Aydogmus; Adem Topkara; Metin Akbulut; Adem Ozkan; Figen Turk; Barbaros Sahin; Gokhan Yuncu

doi:http://dx.doi.org/10.21053/ceo.2015.01508

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자료유형: 학술저널

저자정보: Umit Aydogmus (Pamukkale University) Adem Topkara (Pamukkale University) Metin Akbulut (Pamukkale University) Adem Ozkan (Pamukkale University) Figen Turk (Pamukkale University) Barbaros Sahin (Pamukkale University) Gokhan Yuncu (Liv Hospital)

저널정보: 대한이비인후과학회 Clinical and Experimental Otorhinolaryngology Clinical and Experimental Otorhinolaryngology 제9권 제4호

발행연도: 2016.12

수록면: 358 - 365 (8page)

DOI: http://dx.doi.org/10.21053/ceo.2015.01508

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Objectives. Mucosal 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. Methods. This 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. Results. The 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). Conclusion. The 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.

#Tracheal Stenosis #Mucosal Tissues #Autografts #Airway #Wound Healing

참고문헌 (31)

참고문헌 신청

Haft S. / 2014 / Inflammatory protein expression in human subglottic stenosis tissue mirrors that in a murine model / Ann Otol Rhinol Laryngol 123(1):65~70

Rubikas R. / 2014 / Surgical treatment of non-malignant laryngotracheal stenosis / Eur Arch Otorhinolaryngol 271(9):2481~2487

Gomez-Caro A. / 2011 / Surgical management of benign tracheal stenosis / Multimed Man Cardiothorac Surg 2011(1111)

Grillo HC / 1982 / Primary reconstruction of airway after resection of subglottic laryngeal and upper tracheal stenosis / Ann Thorac Surg 33(1):3~18

Montgomery WW / 1984 / Chronic subglottic stenosis / Otolaryngol Clin North Am 17(1):107~113

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