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Maletzki C, Freiin Grote V, Kalle F, Kleitke T, Zimpfer A, Becker AS, Bergmann-Ewert W, Jonitz-Heincke A, Bader R, Vollmar B, Hackenberg S, Scherzad A, Mlynski R, Strüder D. Establishing safe high hydrostatic pressure devitalization thresholds for autologous head and neck cancer vaccination and reconstruction. Cell Death Discov 2023; 9:390. [PMID: 37872173 PMCID: PMC10593744 DOI: 10.1038/s41420-023-01671-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 09/13/2023] [Accepted: 10/03/2023] [Indexed: 10/25/2023] Open
Abstract
High hydrostatic pressure specifically devitalizes cells and tissues without major changes in their molecular structure. Hence, high hydrostatic pressure may enhance the development of whole-cell anti-tumor vaccines, representing tumor heterogeneity and thus (neo-) antigen diversity. Moreover, safe devitalization of tumor-infiltrated supporting tissue may facilitate reimplantation for functional reconstruction. However, precise high hydrostatic pressure thresholds for safe cancer cell killing are unknown. Here, we show that high hydrostatic pressure of at least 450 MPa is necessary to safely devitalize head and neck squamous cell cancer. A pressure of 300 MPa, which has been used frequently in cancer vaccine preparation, resulted in partial devitalization with 27% live cells in flow cytometry and 4% remaining autofluorescence in cell culture after one week. The remaining cells could form vital tumors in the chorioallantoic membrane assay. In contrast, 450 MPa killed all cells in vitro and prevented tumor outgrowth in ovo. The effectiveness of 450 MPa was attributed to the induction of DNA double-strand breaks, independent of apoptosis, autophagy, or methuosis. Furthermore, 450 MPa continued to induce immunogenic cell death. Our results demonstrate that 450 MPa of high hydrostatic pressure induces safe and sustained devitalization of head and neck cancer cells and tissues. Because of the heterogeneity in pressure resistance, we propose our approach as a starting point for determining the precise thresholds for other cancer entities. Further studies on head and neck cancer should focus on immunological co-cultures, combinations of immune checkpoint inhibition, and accurate anatomical reconstruction with pressure-treated autografts.
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Affiliation(s)
- Claudia Maletzki
- Department of Internal Medicine, Medical Clinic III - Hematology, Oncology, Palliative Medicine, Rostock University Medical Center, Rostock, Germany
| | - Vivica Freiin Grote
- Research Laboratory for Biomechanics and Implant Technology, Department of Orthopedics, Rostock University Medical Centre, Rostock, Germany
| | - Friederike Kalle
- Department of Otorhinolaryngology, Head and Neck Surgery "Otto Körner", Rostock University Medical Center, Rostock, Germany
| | - Thoralf Kleitke
- Department of Otorhinolaryngology, Head and Neck Surgery "Otto Körner", Rostock University Medical Center, Rostock, Germany
| | - Annette Zimpfer
- Institute of Pathology, Rostock University Medical Center, Rostock, Germany
| | - Anne-Sophie Becker
- Institute of Pathology, Rostock University Medical Center, Rostock, Germany
| | - Wendy Bergmann-Ewert
- Core Facility for Cell Sorting and Cell Analysis, University Medical Center Rostock, Rostock, Germany
| | - Anika Jonitz-Heincke
- Research Laboratory for Biomechanics and Implant Technology, Department of Orthopedics, Rostock University Medical Centre, Rostock, Germany
| | - Rainer Bader
- Research Laboratory for Biomechanics and Implant Technology, Department of Orthopedics, Rostock University Medical Centre, Rostock, Germany
| | - Brigitte Vollmar
- Institute for Experimental Surgery, Rostock University Medical Center, Rostock, Germany
| | - Stephan Hackenberg
- Department of Otorhinolaryngology-Head and Neck Surgery, RWTH Aachen University Hospital, Aachen, Germany
| | - Agmal Scherzad
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Wuerzburg, Wuerzburg, Germany
| | - Robert Mlynski
- Department of Otorhinolaryngology, Head and Neck Surgery "Otto Körner", Rostock University Medical Center, Rostock, Germany
| | - Daniel Strüder
- Department of Otorhinolaryngology, Head and Neck Surgery "Otto Körner", Rostock University Medical Center, Rostock, Germany.
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Kryukov AI, Kirasirova EA, Tyutina SI, Sotnikova TN, Frolkina EA, Saydulaev VA. [Implantation materials in reconstructive surgery of the larynx and trachea]. Vestn Otorinolaringol 2022; 87:78-84. [PMID: 35818950 DOI: 10.17116/otorino20228703178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The article presents a literature review, that analyzes the use of implantation materials in reconstructive plastic surgery of the larynx and trachea in patients with local and extended laryngeal-tracheal stenosis, including lumen obliteration. 48 literature sources were studied. The positive and negative aspects of biological and synthetic implant materials use have been determined. The choice of an implantation material that meets all the demands for the complete restoration of the respiratory tract determines the relevance of the problem raised.
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Affiliation(s)
- A I Kryukov
- Pirogov Russian National Research Medical University, Moscow, Russia
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
| | - E A Kirasirova
- Pirogov Russian National Research Medical University, Moscow, Russia
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
| | - S I Tyutina
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
| | - T N Sotnikova
- Davydovsky City Clinical Hospital No. 23, Moscow, Russia
| | - E A Frolkina
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
| | - V A Saydulaev
- National medical reserch center of Otorhinolaryngology Moscow, Moscow, Russia
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Li L, Wang J, Deng D, Shen T, Gan W, Xu F, Liu J, Lv D, Li B, Wang J, Wang J, Chen F, Liu J. Postoperative outcomes of free myocutaneous flap and pedicled myocutaneous flap for reconstruction in locally invasive thyroid carcinoma. Medicine (Baltimore) 2021; 100:e24070. [PMID: 33466165 PMCID: PMC7808483 DOI: 10.1097/md.0000000000024070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 12/03/2020] [Indexed: 02/05/2023] Open
Abstract
Locally invasive thyroid carcinoma (TC) often involves trachea. In such patients, the trachea needs to be reconstructed after surgery. We discuss the postoperative outcome and complications after trachea reconstruction by free myocutaneous flap (FMF) and pedicled myocutaneous flap (PMF).From January 2009 to September 2019, the clinical data of 38 patients with TC were retrospectively analyzed. Demographics, pathologic results, neoplasm staging, surgical protocol, decannulation, subjective speech function, and complications were documented.A total of 38 patients were analyzed (22 FMFs and 16 PMFs). Of the 38 patients, there is a similar rate of decannulation (81.8% in FMF and 75% in PMF), subjective speech function and complications.The FMF reconstruction and the PMF reconstruction have a similar result in terms of postoperative outcome and complications.
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Xu R, Zhu Y, Lu Y, Li W, Jia J. Dexmedetomidine versus midazolam on cough and recovery quality after partial and total laryngectomy - a randomized controlled trial. BMC Anesthesiol 2020; 20:249. [PMID: 32988369 PMCID: PMC7523379 DOI: 10.1186/s12871-020-01168-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 09/21/2020] [Indexed: 12/24/2022] Open
Abstract
Background During emergence from anesthesia after partial and total laryngectomy, excessive airway reflex and systemic hypertension may lead to subcutaneous emphysema, hemorrhage or pneumothorax. Methods American Society of Anesthesiologist physical status III and IV male adults undergoing elective laryngectomy were recruited and randomly allocated to receive either dexmedetomidine (group D) or midazolam (group M). The primary outcome was incidence and severity of cough. Pulse oximetry results (SpO2), heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were also recorded. The visual analog scale and the Ramsay sedation scale were recorded at the points of wakefulness and departure from the post-anesthesia care unit (PACU). Rescue analgesia consumption, the time of spontaneous breath recovery, duration of the PACU stay, and the incidence of adverse effects were also recorded. Results The prevalence of no coughing was significantly higher in group D than in group M at the points of wakefulness and departure. HR, SBP, and DBP were significantly lower in group D compared with group M, and SpO2 was significantly higher in group D than in group M at the moment of laryngectomy. Pain scores were lower in group D than in group M. The Ramsay score at the point of wakefulness was higher in group D than in group M. There was no difference in time to spontaneous breathing recovery, duration of the PACU stay, and incidence of adverse effects. Conclusions Compared with midazolam, dexmedetomidine is an effective alternative to attenuate coughing and hemodynamic changes with a low incidence of adverse events during emergence from anesthesia after partial and total laryngectomy. Trial registration NCT03918889, registered at clinicaltrials.gov, date of registration: March 28, 2019.
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Affiliation(s)
- Rui Xu
- Department of Anesthesiology, The Eye, Ear, Nose and Throat Hospital of Fudan University, Shanghai Medical College of Fudan University, Fenyang Road #83, Shanghai, 200031, People's Republic of China
| | - Yun Zhu
- Department of Oro-maxillofacial Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Yi Lu
- Department of Anesthesiology, The Eye, Ear, Nose and Throat Hospital of Fudan University, Shanghai Medical College of Fudan University, Fenyang Road #83, Shanghai, 200031, People's Republic of China
| | - Wenxian Li
- Department of Anesthesiology, The Eye, Ear, Nose and Throat Hospital of Fudan University, Shanghai Medical College of Fudan University, Fenyang Road #83, Shanghai, 200031, People's Republic of China.
| | - Jie Jia
- Department of Anesthesiology, The Eye, Ear, Nose and Throat Hospital of Fudan University, Shanghai Medical College of Fudan University, Fenyang Road #83, Shanghai, 200031, People's Republic of China.
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Xie DX, Rehman SC, Francis DO, Netterville JL, Garrett CG, Gelbard A, Lipscomb B, Wootten CT. Association Between Red Blood Cell Distribution Width and Outcomes of Open Airway Reconstruction Surgery in Adults. JAMA Otolaryngol Head Neck Surg 2020; 145:210-215. [PMID: 30629096 DOI: 10.1001/jamaoto.2018.3793] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Airway reconstruction for adults with laryngotracheal stenosis (LTS) is directed toward improving airway caliber to mitigate the patient's dyspnea and achieve prosthesis-free breathing (ie, without tracheostomy, intraluminal stent, or T-tube). Despite the importance of preoperative risk stratification to minimize postoperative complications, consensus on an objective predictive algorithm for open airway reconstruction is lacking. Objective To determine whether the ability to achieve a prosthesis-free airway in adults after open airway reconstruction is associated with red blood cell distribution width (RDW) at the time of surgery. Design, Setting, and Participants Case series study investigating 92 consecutive patients 18 years and older with laryngotracheal stenosis who underwent open airway reconstruction at a US tertiary care hospital from January 1, 2006, to January 1, 2017. Main Outcomes and Measures The main outcome was a prosthesis-free airway (absence of tracheostomy, intraluminal stent, or T-tubes) at last follow-up. Multivariate logistic regression modeling was used to identify independent factors associated with this outcome. Results Of the 92 patients who met inclusion criteria, the median (interquartile range) age was 44 (33.0-60.3) years; 50 (53%) were female, and 82 (89%) were white. In all, 74 patients (80%) were prosthesis free at the last follow-up (mean, 833 days; 95% CI, 10-4229 days). In multivariate analyses, airway decannulation was significantly correlated with reduced RDW (odds ratio [OR], 0.40; 95% CI, 0.19-0.84) and the absence of posterior glottic stenosis (OR, 0.12; 95% CI, 0.04-0.37). Conclusions and Relevance These data suggest that surgical success in open airway reconstruction is significantly associated with RDW and whether the patient had posterior glottic stenosis. The RDW is a routine laboratory parameter that may provide some insight to the preoperative probability of prosthesis removal, facilitate risk stratification, promote informed patient decision making, and optimize health care resource management.
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Affiliation(s)
- Deborah X Xie
- Vanderbilt University School of Medicine. Nashville, Tennessee.,Surgical Outcomes Center for Kids, Vanderbilt University Medical Center. Nashville, Tennessee
| | - Saad C Rehman
- Vanderbilt University School of Medicine. Nashville, Tennessee.,Surgical Outcomes Center for Kids, Vanderbilt University Medical Center. Nashville, Tennessee
| | - David O Francis
- Division of Otolaryngology, Wisconsin Surgical Outcomes Research Program, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison
| | - James L Netterville
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - C Gaelyn Garrett
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Alexander Gelbard
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Brittany Lipscomb
- Surgical Outcomes Center for Kids, Vanderbilt University Medical Center. Nashville, Tennessee.,Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Christopher T Wootten
- Surgical Outcomes Center for Kids, Vanderbilt University Medical Center. Nashville, Tennessee.,Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
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6
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Liu J, Lu D, Deng D, Wang J, Gan W, Zou J, Chen F, Yang H. Free posterior tibial artery perforator flap for 2-stage tracheal reconstruction in patients after resection of well-differentiated thyroid carcinoma invading the trachea. Head Neck 2019; 41:2249-2255. [PMID: 30729609 PMCID: PMC6618072 DOI: 10.1002/hed.25675] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 12/09/2018] [Accepted: 01/15/2019] [Indexed: 02/05/2023] Open
Abstract
Background The present study was conducted to explore the efficacy of using a free posterior tibial artery perforator flap (FPTAPF) for trachea reconstruction after resection of well‐differentiated thyroid carcinoma (WDTC) invading the trachea. Methods We retrospectively collected and analyzed clinical and surgical data from 14 patients who underwent tracheal reconstruction using a FPTAPF after resection of WDTC invading the trachea between August 2014 and July 2017. Results Satisfactory tracheal structure and functional recovery were obtained in 11 of the 14 patients. One patient had breathing difficulties after tracheostomy closure tests because of bilateral recurrent laryngeal nerve damage caused by disease invasion. Tracheostomy incision was not closed in 2 patients because they received postoperative adjuvant radioactive iodine 131 treatment. Conclusion Satisfactory tracheal reconstruction results were achieved in patients with resection of WDTC invading the trachea, indicating that a FPTAPF is a safe and reliable choice for management.
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Affiliation(s)
- Jun Liu
- Department of Otorhinolaryngology, Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Dan Lu
- Department of Otorhinolaryngology, Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Di Deng
- Department of Otorhinolaryngology, Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Ji Wang
- Department of Otorhinolaryngology, Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Weigang Gan
- Department of Otorhinolaryngology, Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Jian Zou
- Department of Otorhinolaryngology, Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Fei Chen
- Department of Otorhinolaryngology, Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Hui Yang
- Department of Otorhinolaryngology, Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
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7
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Lin X, Wen G, Wang S, Lu H, Li C, Wang X. Expression and role of EGFR, cyclin D1 and KRAS in laryngocarcinoma tissues. Exp Ther Med 2018; 17:782-790. [PMID: 30651863 PMCID: PMC6307426 DOI: 10.3892/etm.2018.7027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 10/26/2018] [Indexed: 12/14/2022] Open
Abstract
Epidermal growth factor receptor (EGFR), cyclin D1 and KRAS proto-oncogene, GTPase (KRAS) genes serve roles in the occurrence and development of tumors. The aim of the current study was to investigate the expression levels of EGFR, cyclin D1 and KRAS in laryngocarcinoma tissues and their association with clinical features. In addition, correlation between the expression levels of EGFR, cyclin D1 and KRAS was analyzed in laryngocarcinoma tissues. The expression levels of EGFR, cyclin D1 and KRAS in 46 patients with laryngocarcinoma and 20 patients with vocal cord polyps as the control group were determined using Super Vision immunohistochemical staining assay kits. The differences in clinical and pathological parameters between groups were statistically analyzed using SPSS software version 16.0. The expression rates of EGFR, cyclin D1 and KRAS were 71.7, 52.2 and 39.1%, respectively in laryngocarcinoma tissues, and 10.0, 5.0 and 10.0%, respectively in vocal cord polyps. There was a positive correlation between the expression levels of EGFR, cyclin D1 and KRAS. The expression of these genes was also closely associated with the clinical stage, treatment response and prognosis of patients with laryngocarcinoma. Multivariate analysis of prognosis using the Cox regression model indicated that EGFR expression in laryngocarcinoma tissues and the clinical stage of patients with laryngocarcinoma were closely associated with patient prognosis. The results of the current study indicated that EGFR, cyclin D1 and KRAS were synergistically involved in the occurrence and development of laryngocarcinoma, directly affecting the prognosis of patients. Additionally, high expression of EGFR, cyclin D1 and KRAS facilitated the invasion and metastasis of laryngocarcinoma cells. The expression of EGFR in laryngocarcinoma tissues and clinical stage were two independent risk factors affecting the prognosis of patients.
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Affiliation(s)
- Xinsheng Lin
- Department of Otolaryngology-Head and Neck Surgery, Shantou Central Hospital, Shantou, Guangdong 515031, P.R. China
| | - Guofeng Wen
- Department of Otolaryngology-Head and Neck Surgery, Shantou Central Hospital, Shantou, Guangdong 515031, P.R. China
| | - Shuangle Wang
- Department of Otolaryngology-Head and Neck Surgery, Shantou Central Hospital, Shantou, Guangdong 515031, P.R. China
| | - Hangui Lu
- Department of Otolaryngology-Head and Neck Surgery, Shantou Central Hospital, Shantou, Guangdong 515031, P.R. China
| | - Chuangwei Li
- Department of Otolaryngology-Head and Neck Surgery, Shantou Central Hospital, Shantou, Guangdong 515031, P.R. China
| | - Xin Wang
- Department of Otolaryngology-Head and Neck Surgery, The First Hospital of Jilin University, Changchun, Jilin 130000, P.R. China
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Shin SC, Park HY, Shin N, Jung DW, Kwon HK, Kim JM, Wang SG, Lee JC, Sung ES, Park GC, Lee BJ. Evaluation of decellularized xenogenic porcine auricular cartilage as a novel biocompatible filler. J Biomed Mater Res B Appl Biomater 2018; 106:2708-2715. [DOI: 10.1002/jbm.b.34088] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 11/24/2017] [Accepted: 01/08/2018] [Indexed: 11/10/2022]
Affiliation(s)
- Sung-Chan Shin
- Department of Otorhinolaryngology-Head and Neck Surgery; Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital; Pusan Republic of Korea
| | - Hee Young Park
- Department of Otorhinolaryngology-Head and Neck Surgery; Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital; Pusan Republic of Korea
| | - Nari Shin
- Department of Pathology; Hanmaeum Changwon Hospital; Changwon Gyeongsangnamdo Republic of Korea
- Department of Pathology; Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Yangsan Hospital; Yangsan Gyeongsangnamdo Republic of Korea
| | - Da-Woon Jung
- Department of Otorhinolaryngology-Head and Neck Surgery; Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital; Pusan Republic of Korea
| | - Hyun-Keun Kwon
- Department of Otorhinolaryngology-Head and Neck Surgery; Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital; Pusan Republic of Korea
| | - Ji Min Kim
- Department of Otorhinolaryngology-Head and Neck Surgery; Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital; Pusan Republic of Korea
| | - Soo-Geun Wang
- Department of Otorhinolaryngology-Head and Neck Surgery; Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital; Pusan Republic of Korea
| | - Jin-Choon Lee
- Department of Otorhinolaryngology-Head and Neck Surgery; Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Yangsan Hospital; Yangsan Gyeongsangnamdo Republic of Korea
| | - Eui-Suk Sung
- Department of Otorhinolaryngology-Head and Neck Surgery; Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Yangsan Hospital; Yangsan Gyeongsangnamdo Republic of Korea
| | - Gi Cheol Park
- Department of Otorhinolaryngology-Head and Neck Surgery; Sungkyunkwan University School of Medicine, Samsung Changwon Hospital Changwon; Gyeongsangnamdo Republic of Korea
| | - Byung-Joo Lee
- Department of Otorhinolaryngology-Head and Neck Surgery; Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital; Pusan Republic of Korea
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Yang H, Chen Z, Zhou SH, Wang QY, Weng LX, Wang F, Wu TT, Zhou ML, Bao YY. Traumatic laryngotracheal stenosis treated by hyoid-sternohyoid osseomuscular flap combined with xenogenic acellular dermal matrix: A case report and literature review. J Int Med Res 2017; 45:1486-1494. [PMID: 28480810 PMCID: PMC5718716 DOI: 10.1177/0300060517705985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective The treatment of laryngotracheal stenosis is a major therapeutic challenge. Various treatments include observation, medical management, and surgical management. The most effective surgical management is resection and reconstruction. To the authors’ knowledge, no reports have described the use of xenogenic acellular dermal matrix (ADM) for laryngotracheal stenosis. Methods A 27-year-old man presented with hemoptysis of the neck due to a traffic accident. Emergency orotracheal intubation was performed. Tracheostomy was then performed under local anesthesia. Computed tomography revealed fractures of the right thyroid cartilage and posterior arc of the cricoid cartilage and stenosis of the subglottis and first and second tracheal rings. We used a composite hyoid–sternohyoid osseomuscular flap with xenogenic ADM and a straight silicone tube as a lumen stent to reconstruct the laryngotracheal stenosis. Results Surgical recovery was uneventful. The tracheotomy opening was changed to a metal tube 5 days postoperatively. Four months postoperatively, the silicone tube was endoscopically removed under local anesthesia. The patient was decannulated 20 days later. The patient satisfied with his voice, respiration, and deglutition at the 16-month postoperative follow-up. Conclusion The use of ADM for laryngotracheal stenosis may reduce the growth of granulation tissues and promote the repair process.
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Affiliation(s)
- Hang Yang
- 1 Department of Otorhinolaryngology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.,2 Department of Otorhinolaryngology, People's Hospital of Jiangshan City, Zhejiang Province, China
| | - Zhe Chen
- 1 Department of Otorhinolaryngology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Shui-Hong Zhou
- 1 Department of Otorhinolaryngology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Qin-Yin Wang
- 1 Department of Otorhinolaryngology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Li-Xia Weng
- 3 Department of Operation Room, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Fang Wang
- 3 Department of Operation Room, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Ting-Ting Wu
- 1 Department of Otorhinolaryngology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Min-Li Zhou
- 1 Department of Otorhinolaryngology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yang-Yang Bao
- 1 Department of Otorhinolaryngology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
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10
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Li P, Li S, Tang Q, He X, Yin D, Wang S, Yang X. Reconstruction of human oncological tracheal defects with xenogenic acellular dermal matrix. Auris Nasus Larynx 2017; 44:237-240. [DOI: 10.1016/j.anl.2016.04.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2016] [Revised: 04/01/2016] [Accepted: 04/08/2016] [Indexed: 10/21/2022]
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11
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Preoperative assessment and classification of benign laryngotracheal stenosis: a consensus paper of the European Laryngological Society. Eur Arch Otorhinolaryngol 2015; 272:2885-96. [DOI: 10.1007/s00405-015-3635-4] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Accepted: 04/19/2015] [Indexed: 12/19/2022]
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12
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Sun A, Meng Q, Li W, Liu S, Chen W. Construction of tissue-engineered laryngeal cartilage with a hollow, semi-flared shape using poly(3-hydroxybutyrate-co-3-hydroxyhexanoate) as a scaffold. Exp Ther Med 2015; 9:1482-1488. [PMID: 25780456 PMCID: PMC4353787 DOI: 10.3892/etm.2015.2262] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Accepted: 12/23/2014] [Indexed: 12/11/2022] Open
Abstract
The aim of the present study was to construct tissue-engineered laryngeal cartilage with a hollow, semi-flared shape using a poly(3-hydroxybutyrate-co-3-hydroxyhexanoate) (PHBHH) scaffold. Porous PHBHH was prepared and formed into a hollow, semi-flared shape, and the cell-material composites were cultured for one week in vitro prior to implantation in vivo. Cells of the nine rabbits of the experimental group were filled and encapsulated in the myofascial flap-shaping material composite for in situ implantation. The three rabbits in the control group were treated with the shaping material without the chondrocytes. Cartilage regeneration was assessed at six, 12 and 18 weeks after surgery. In the experimental group, the shape and porosity of the material were ideal, the cells exhibited good adhesion with the material and the myofascial flap blood supply was rich. The engineered laryngeal cartilage with the hollow, semi-flared shape was ideally formed, and the cartilage formed at six weeks after the surgery. Further maturation of the cartilage was observed at 12 and 18 weeks after the surgery. PHBHH was a suitable material for the formation of a hollow, semi-flared shape with good cellular compatibility. Myofascial flap filling and wrapping can be used to build tissue-engineered laryngeal cartilage with a hollow, semi-flared shape.
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Affiliation(s)
- Anke Sun
- Department of Otolaryngology, General Hospital of Shenyang Military Area Command, Shenyang, Liaoning 110016, P.R. China
| | - Qingyan Meng
- Department of Burns and Aesthetic Medicine, General Hospital of Shenyang Military Area Command, Shenyang, Liaoning 110016, P.R. China
| | - Wantong Li
- Department of Burns and Aesthetic Medicine, General Hospital of Shenyang Military Area Command, Shenyang, Liaoning 110016, P.R. China
| | - Songbo Liu
- Department of Microsurgery, General Hospital of Shenyang Military Area Command, Shenyang, Liaoning 110016, P.R. China
| | - Wei Chen
- Department of Experimental Medicine, General Hospital of Shenyang Military Area Command, Shenyang, Liaoning 110016, P.R. China
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13
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Yagudin RK, Yagudin KF. [The experience with the use of the two-step laryngotracheoplasty for the management of subglottic and combined subglottic and upper tracheal cicatrical stenosis in the adult patients]. Vestn Otorinolaringol 2015; 80:53-59. [PMID: 26145746 DOI: 10.17116/otorino201580253-59] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The objective of the present retrospective study was to evaluate the clinical experience with the use of the two-step laryngotracheoplasty for the treatment of subglottic and combined subglottic and upper tracheal cicatrical stenosis in the adult patients during the period between 2003 and 2012. A total of 13 patients were retrospectively reviewed following the surgical treatment for the management of subglottic and combined subglottic and upper tracheal cicatrical stenosis based at the Lugansk regional clinical hospital. The effectiveness of two-stage laryngotracheoplasty was estimated to be 84.6%. The number of the surgical procedures per patient depended on the extent of tracheal stenosis while the overall rehabilitation period mainly depended on the severity of the concomitant pathologies. The technical aspects and the results of the surgical treatment are discussed.
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Affiliation(s)
- R K Yagudin
- Lugansk State Medical University, Lugansk, the Ukraine, 91033
| | - K F Yagudin
- Lugansk State Medical University, Lugansk, the Ukraine, 91033
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14
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Wierzbicka M, Leszczyńska M, Szyfter W. [Re-evaluation of 191 larynx cancer surgeries according to the Open Partial Horizontal Laryngectomies classification proposed by European Laryngological Society working committee in 2014]. Otolaryngol Pol 2014; 68:281-6. [PMID: 25152380 DOI: 10.1016/j.otpol.2014.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 07/08/2014] [Accepted: 07/10/2014] [Indexed: 10/25/2022]
Abstract
AIM of study was to present material of open partial horizontal laryngectomies (OPHL) in T1b, T2 and T3 larynx cancer treatment in single tertiary referral institution. MATERIAL AND METHODS Retrospective analysis of operating protocols in patients treated in Poznań ENT University Department between 2000-2012 with glottis (T1b - 185, T2 - 185, T3 - 231) and supraglottis tumors (T1 - 80, T2 - 104, T3 - 206), potentially available for organ preservation treatment. Transoral laser microsurgery, OPHL, radiotherapy and total laryngectomy were treatment options in 210, 191, 271 and 326 patients respectively. OPHL was applied in glottic tumors: 21 - T1b, 103 - T2, 27 - T3 and in supraglottic tumors: 4 - T1, 29 - T2. All procedures were re-evaluated acc. to European Laryngogical Society working committee on nomenclature new classification presented in 2014. RESULTS There was no discrepancies in supraglottic laryngectomies (4 cases), classified as OPHL Typ I. All the rest: 84 transglottic, 96 supracricoid with CHEP and 7 supracricoid with CHP laryngectomies were re-classified into Typ II (172) and Type III (15) OPHL. Thus, revision of inferior incision changed classification of procedure into supratracheal laryngectomy in 15 cases. Transglottic laryngectomies, in which upper part of thyroid cartilage was preserved and crito-thyreo-pexy was performed (84 pts), have not been distinguished any more. In 7 cases superior incision included epiglottis; thus 165 patients were distinguished as Typ II a and 7 patients as Typ IIb OPHL. The most pronounced difference was stated in description of structures additionally included into surgical specimen: arytenoid (+ARY) in 24, crico-arytenoid-unit (+CAU) in 5 and piriform sinus (+PIR) in 17 cases; none had the base of tongue (+BOT) resected. CONCLUSIONS In 36/191 additional structures and in 15/191 the cricoid ring resection was re-evaluated and pointed out. All these data were available retrospectively in the operating protocols but not pronounced in surgery headlines. Thanks to the univocal, simple new classification all operation details can be included into operation title.
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Affiliation(s)
- Małgorzata Wierzbicka
- Klinika Otolaryngologii i Onkologii Laryngologicznej, Uniwersytet Medyczny im. Karola Marcinkowskiego w Poznaniu, Kierownik: prof. dr hab. med. Witold Szyfter, Poznań, Polska.
| | - Małgorzata Leszczyńska
- Klinika Otolaryngologii i Onkologii Laryngologicznej, Uniwersytet Medyczny im. Karola Marcinkowskiego w Poznaniu, Kierownik: prof. dr hab. med. Witold Szyfter, Poznań, Polska
| | - Witold Szyfter
- Klinika Otolaryngologii i Onkologii Laryngologicznej, Uniwersytet Medyczny im. Karola Marcinkowskiego w Poznaniu, Kierownik: prof. dr hab. med. Witold Szyfter, Poznań, Polska
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