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Yan Y, Yao R, Zhao J, Chen K, Duan L, Wang T, Zhang S, Guan J, Zheng Z, Wang X, Liu Z, Li Y, Li G. Implantable nerve guidance conduits: Material combinations, multi-functional strategies and advanced engineering innovations. Bioact Mater 2022; 11:57-76. [PMID: 34938913 PMCID: PMC8665266 DOI: 10.1016/j.bioactmat.2021.09.030] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/17/2021] [Accepted: 09/26/2021] [Indexed: 01/15/2023] Open
Abstract
Nerve guidance conduits (NGCs) have attracted much attention due to their great necessity and applicability in clinical use for the peripheral nerve repair. Great efforts in recent years have been devoted to the development of high-performance NGCs using various materials and strategies. The present review provides a comprehensive overview of progress in the material innovation, structural design, advanced engineering technologies and multi functionalization of state-of-the-art nerve guidance conduits NGCs. Abundant advanced engineering technologies including extrusion-based system, laser-based system, and novel textile forming techniques in terms of weaving, knitting, braiding, and electrospinning techniques were also analyzed in detail. Findings arising from this review indicate that the structural mimetic NGCs combined with natural and synthetic materials using advanced manufacturing technologies can make full use of their complementary advantages, acquiring better biomechanical properties, chemical stability and biocompatibility. Finally, the existing challenges and future opportunities of NGCs were put forward aiming for further research and applications of NGCs.
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Affiliation(s)
- Yixin Yan
- National Engineering Laboratory for Modern Silk, College of Textile and Clothing Engineering, Soochow University, Suzhou, 215123, China
- Department of Materials, University of Manchester, Oxford Road, Manchester, M13 9PL, UK
| | - Ruotong Yao
- National Engineering Laboratory for Modern Silk, College of Textile and Clothing Engineering, Soochow University, Suzhou, 215123, China
| | - Jingyuan Zhao
- National Engineering Laboratory for Modern Silk, College of Textile and Clothing Engineering, Soochow University, Suzhou, 215123, China
| | - Kaili Chen
- Department of Materials, Imperial College London, SW7 2AZ, UK
| | - Lirong Duan
- National Engineering Laboratory for Modern Silk, College of Textile and Clothing Engineering, Soochow University, Suzhou, 215123, China
| | - Tian Wang
- Wilson College of Textiles, North Carolina State University, Raleigh, 27695, USA
| | - Shujun Zhang
- Research Centre of Printed Flexible Electronics, School of Materials Science and Engineering, Harbin Institute of Technology, Shenzhen, 518055, China
| | - Jinping Guan
- National Engineering Laboratory for Modern Silk, College of Textile and Clothing Engineering, Soochow University, Suzhou, 215123, China
| | - Zhaozhu Zheng
- National Engineering Laboratory for Modern Silk, College of Textile and Clothing Engineering, Soochow University, Suzhou, 215123, China
| | - Xiaoqin Wang
- National Engineering Laboratory for Modern Silk, College of Textile and Clothing Engineering, Soochow University, Suzhou, 215123, China
| | - Zekun Liu
- Department of Materials, University of Manchester, Oxford Road, Manchester, M13 9PL, UK
| | - Yi Li
- Department of Materials, University of Manchester, Oxford Road, Manchester, M13 9PL, UK
| | - Gang Li
- National Engineering Laboratory for Modern Silk, College of Textile and Clothing Engineering, Soochow University, Suzhou, 215123, China
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Sharma D, Iyer S, Subramaniam S, Ramu J, Sharma M, Nambiar A, Unni A, S S. Evaluation of Antigenicity of Components of Tracheal Allotransplant and Effect of Immunosuppressant Regime in a Rodent Model. Indian J Plast Surg 2020; 53:357-362. [PMID: 33402765 PMCID: PMC7775257 DOI: 10.1055/s-0040-1721860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Background Tracheal transplantation seems to be the logical step in the process of reconstruction of the trachea following a long-segment resection, which is usually done to treat malignant disease or benign stenosis of the airway caused by a traumatic, congenital, inflammatory, or iatrogenic lesion. Immunosuppression following transplant is essential but not ideal after oncoresection. Methods The tracheal allografts, harvested from Sprague Dawley rats, were implanted in the Wistar strain rat. The harvested tracheal grafts were divided into groups and subgroups, based on the layers of trachea, method of decellularization, and immunosuppression. The antigenicity of different layers of trachea and the effect of various decellularization methods were studied within three time frames, that is, day 3, 9, and 15. Result On structural analysis, the day 3 and day 15 samples showed no meaningful comparison could be made, due to extensive neutrophil infiltration in all three layers. The day 9 tracheal grafts showed loss of epithelium, with no signs of regeneration in most of the allografts. The subepithelial lymphoid infiltration was found to be severe in nonimmunosuppressed allografts. The group in which both inner and outer layers were removed showed moderate-to-severe infiltrate of lymphoid cells in all the allografts, but there was no cartilage loss, irrespective of the method of decellularization. The irradiated specimens retained the cartilage but showed extensive ischemic damage. Conclusion Rat trachea is a good model for tracheal transplant research but not adequately sturdy to sustain mechanical debridement. Irradiation and chemical decellularization eliminates the immune response but causes intense ischemic damage. Out of the three time frames, day 9 seemed to be the best to study the immune response. To substantiate the results obtained in this study, the immunohistochemical study of the allografts is needed to be performed among a larger group of animals.
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Affiliation(s)
- Dimpy Sharma
- Department of Plastic and Reconstructive Surgery, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
| | - Subramania Iyer
- Department of Plastic and Reconstructive Surgery, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India.,Department of Head and Neck Surgical Oncology, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
| | - Sobha Subramaniam
- Department of Pulmonary Medicine, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
| | - Janarthanan Ramu
- Department of Plastic and Reconstructive Surgery, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
| | - Mohit Sharma
- Department of Plastic and Reconstructive Surgery, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
| | - Ajit Nambiar
- Department of Clinical Pathology, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
| | - Akk Unni
- Department of Central Animal Research Facility, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
| | - Sivanarayanan S
- Department of Central Animal Research Facility, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
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Etienne H, Fabre D, Gomez Caro A, Kolb F, Mussot S, Mercier O, Mitilian D, Stephan F, Fadel E, Dartevelle P. Tracheal replacement. Eur Respir J 2018; 51:51/2/1702211. [DOI: 10.1183/13993003.02211-2017] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 11/29/2017] [Indexed: 11/05/2022]
Abstract
Tracheal reconstruction is one of the greatest challenges in thoracic surgery when direct end-to-end anastomosis is impossible or after this procedure has failed. The main indications for tracheal reconstruction include malignant tumours (squamous cell carcinoma, adenoid cystic carcinoma), tracheoesophageal fistula, trauma, unsuccessful surgical results for benign diseases and congenital stenosis. Tracheal substitutes can be classified into five types: 1) synthetic prosthesis; 2) allografts; 3) tracheal transplantation; 4) tissue engineering; and 5) autologous tissue composite. The ideal tracheal substitute is still unclear, but some techniques have shown promising clinical results. This article reviews the advantages and limitations of each technique used over the past few decades in clinical practice. The main limitation seems to be the capacity for tracheal tissue regeneration. The physiopathology behind this has yet to be fully understood. Research on stem cells sparked much interest and was thought to be a revolutionary technique; however, the poor long-term results of this approach highlight that there is a long way to go in this research field. Currently, an autologous tissue composite, with or without a tracheal allograft, is the only long-term working solution for every aetiology, despite its technical complexity and setbacks.
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Rehmani SS, Al-Ayoubi AM, Ayub A, Barsky M, Lewis E, Flores R, Lebovics R, Bhora FY. Three-Dimensional-Printed Bioengineered Tracheal Grafts: Preclinical Results and Potential for Human Use. Ann Thorac Surg 2017; 104:998-1004. [DOI: 10.1016/j.athoracsur.2017.03.051] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 03/07/2017] [Accepted: 03/27/2017] [Indexed: 01/30/2023]
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Nematollahi Z, Tafazzoli-Shadpour M, Zamanian A, Seyedsalehi A, Mohammad-Behgam S, Ghorbani F, Mirahmadi F. Fabrication of Chitosan Silk-based Tracheal Scaffold Using Freeze-Casting Method. IRANIAN BIOMEDICAL JOURNAL 2017; 21:228-39. [PMID: 28131109 PMCID: PMC5459938 DOI: 10.18869/acadpub.ibj.21.4.228] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Background Since the treatments of long tracheal lesions are associated with some limitations, tissue engineered trachea is considered as an alternative option. This study aimed at preparing a composite scaffold, based on natural and synthetic materials for tracheal tissue engineering. Methods Nine chitosan silk-based scaffolds were fabricated using three freezing rates (0.5, 1, and 2°C/min) and glutaraldehyde (GA) concentrations (0, 0.4, and 0.8 wt%). Samples were characterized, and scaffolds having mechanical properties compatible with those of human trachea and proper biodegradability were selected for chondrocyte cell seeding and subsequent biological assessments. Results The pore sizes were highly influenced by the freezing rate and varied from 135.3×372.1 to 37.8×83.4 µm. Swelling and biodegradability behaviors were more affected by GA rather than freezing rate. Tensile strength raised from 120 kPa to 350 kPa by an increment of freezing rate and GA concentration. In addition, marked stiffening was demonstrated by increasing elastic modulus from 1.5 MPa to 12.2 MPa. Samples having 1 and 2°C/min of freezing rate and 0.8 wt% GA concentration made a non-toxic, porous structure with tensile strength and elastic modulus in the range of human trachea, facilitating the chondrocyte proliferation. The results of 21-day cell culture indicated that glycosaminoglycans content was significantly higher for the rate of 2°C/min (12.04 µg/min) rather than the other (9.6 µg/min). Conclusion A homogenous porous structure was created by freeze drying. This allows the fabrication of a chitosan silk scaffold cross-linked by GA for cartilage tissue regeneration with application in tracheal regeneration.
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Affiliation(s)
- Zeinab Nematollahi
- Faculty of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran
| | | | - Ali Zamanian
- Materials and Energy Research Center, Karaj, Iran
| | - Amir Seyedsalehi
- Faculty of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran
| | - Shadmehr Mohammad-Behgam
- Tracheal Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fariba Ghorbani
- Tracheal Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereshte Mirahmadi
- Faculty of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran
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Zhu J, Jiang X, Zhong J, Duan Y. Polymer brushes and their possible applications in artificial cilia research. Mol Med Rep 2017; 15:3936-3942. [DOI: 10.3892/mmr.2017.6533] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Accepted: 02/20/2017] [Indexed: 11/06/2022] Open
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Ghorbani F, Feizabadi M, Farzanegan R, Vaziri E, Samani S, Lajevardi S, Moradi L, Shadmehr MB. An Investigation of Topics and Trends of Tracheal Replacement Studies Using Co-Occurrence Analysis. TISSUE ENGINEERING PART B-REVIEWS 2016; 23:118-127. [PMID: 27758155 DOI: 10.1089/ten.teb.2016.0254] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
This study evaluated tracheal regeneration studies using scientometric and co-occurrence analysis to identify the most important topics and assess their trends over time. To provide the adequate search options, PubMed, Scopus, and Web of Science (WOS) were used to cover various categories such as keywords, countries, organizations, and authors. Search results were obtained by employing Bibexcel. Co-occurrence analysis was applied to evaluate the publications. Finally, scientific maps, author's network, and country contributions were depicted using VOSviewer and NetDraw. Furthermore, the first 25 countries and 130 of the most productive authors were determined. Regarding the trend analysis, 10 co-occurrence terms out of highly frequent words were examined at 5-year intervals. Our findings indicated that the field of trachea regeneration has tested different approaches over the time. In total, 65 countries have contributed to scientific progress both in experimental and clinical fields. Special keywords such as tissue engineering and different types of stem cells have been increasingly used since 1995. Studies have addressed topics such as angiogenesis, decellularization methods, extracellular matrix, and mechanical properties since 2011. These findings will offer evidence-based information about the current status and trends of tracheal replacement research topics over time, as well as countries' contributions.
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Affiliation(s)
- Fariba Ghorbani
- 1 Tracheal Diseases Research Center (TDRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences , Tehran, Iran
| | - Mansoureh Feizabadi
- 2 Sabzevar University of Medical Sciences, Faculty of Medicine, Sabzevar, Iran
| | - Roya Farzanegan
- 1 Tracheal Diseases Research Center (TDRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences , Tehran, Iran
| | - Esmaeil Vaziri
- 3 University of Zabol, Faculty of Humanities, Department of Information Science and Knowledge Studies, Zabol, Iran
| | - Saeed Samani
- 4 Department of Tissue Engineering & Applied Cell Sciences, School of Advanced Technologies in Medicine , Tehran, Iran
| | | | - Lida Moradi
- 4 Department of Tissue Engineering & Applied Cell Sciences, School of Advanced Technologies in Medicine , Tehran, Iran
| | - Mohammad Behgam Shadmehr
- 1 Tracheal Diseases Research Center (TDRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences , Tehran, Iran
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Debry C, Dupret-Bories A, Vrana NE, Hemar P, Lavalle P, Schultz P. Laryngeal replacement with an artificial larynx after total laryngectomy: The possibility of restoring larynx functionality in the future. Head Neck 2014; 36:1669-73. [DOI: 10.1002/hed.23621] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Revised: 10/22/2013] [Accepted: 02/06/2014] [Indexed: 11/10/2022] Open
Affiliation(s)
- Christian Debry
- Institut National de la Santé et de la Recherche Médicale; INSERM, UMR-S 1121, “Biomatériaux et Bioingénierie,” 11 rue Humann F-67085 Strasbourg Cedex France
- Faculté de Chirurgie Dentaire; Université de Strasbourg, 1 Place de l'Hôpital; 67000 Strasbourg France
- Hôpitaux Universitaires de Strasbourg, Service Oto-Rhino-Laryngologie; 67098 Strasbourg France
| | - Agnes Dupret-Bories
- Institut National de la Santé et de la Recherche Médicale; INSERM, UMR-S 1121, “Biomatériaux et Bioingénierie,” 11 rue Humann F-67085 Strasbourg Cedex France
- Hôpitaux Universitaires de Strasbourg, Service Oto-Rhino-Laryngologie; 67098 Strasbourg France
| | - Nihal E. Vrana
- Protip SAS, 8 Place de l'Hôpital; 67000 Strasbourg France
| | - Patrick Hemar
- Hôpitaux Universitaires de Strasbourg, Service Oto-Rhino-Laryngologie; 67098 Strasbourg France
| | - Philippe Lavalle
- Institut National de la Santé et de la Recherche Médicale; INSERM, UMR-S 1121, “Biomatériaux et Bioingénierie,” 11 rue Humann F-67085 Strasbourg Cedex France
- Faculté de Chirurgie Dentaire; Université de Strasbourg, 1 Place de l'Hôpital; 67000 Strasbourg France
| | - Philippe Schultz
- Institut National de la Santé et de la Recherche Médicale; INSERM, UMR-S 1121, “Biomatériaux et Bioingénierie,” 11 rue Humann F-67085 Strasbourg Cedex France
- Hôpitaux Universitaires de Strasbourg, Service Oto-Rhino-Laryngologie; 67098 Strasbourg France
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Jones MC, Rueggeberg FA, Faircloth HA, Cunningham AJ, Bush CM, Prosser JD, Waller JL, Postma GN, Weinberger PM. Defining the biomechanical properties of the rabbit trachea. Laryngoscope 2014; 124:2352-8. [PMID: 24782429 DOI: 10.1002/lary.24739] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Revised: 04/02/2014] [Accepted: 04/22/2014] [Indexed: 11/11/2022]
Abstract
OBJECTIVES/HYPOTHESIS Surgical advancements rely heavily on validated animal models. The New Zealand White (NZW) rabbit is a widely used model for airway research, including regenerative medicine applications. Currently, the biomechanical properties of the normal rabbit trachea are not known. Our objective was to define these properties to assist in the standardization and understanding of future airway research using this model. STUDY DESIGN Laboratory-based study. METHODS Fresh tracheas from four adult NZW rabbits were dissected into 20 segments. To examine the biomechanical properties, segments were subjected to uniaxial tension (n = 9) and compression (n = 11) testing. Yield and maximum load (tension) and force at 50% displacement (compression) were recorded, and differences between segments were examined using analysis of covariance. RESULTS Normative data for native rabbit trachea show mean maximum load = 6.44 newtons (N), yield load = 5.93 N, and compressive strength = 2.10 N. In addition to establishing the baseline measurements, statistically significant differences in tensile measures based on location along the trachea and diameter were identified. Proximal segments had significantly higher maximum load (P = .0029) and yield load (P = .0062) than distal segments. Association between diameter and both maximum load (P = .0139) and yield load (P = .0082) was observed. CONCLUSIONS The adult NZW rabbit trachea is intrinsically less able to withstand tensile and compressive forces, compared to other airway models such as sheep or cadaveric human. Establishment of normative values will enable future research into changes in tracheal biomechanical properties during regenerative medicine manipulation and processing.
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Affiliation(s)
- Matthew C Jones
- Center for Voice, Airway and Swallowing, Department of Otolaryngology, Georgia Regents University, Augusta, Georgia, U.S.A
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Vrana NE, Dupret-Bories A, Bach C, Chaubaroux C, Coraux C, Vautier D, Boulmedais F, Haikel Y, Debry C, Metz-Boutigue MH, Lavalle P. Modification of macroporous titanium tracheal implants with biodegradable structures: tracking in vivo integration for determination of optimal in situ epithelialization conditions. Biotechnol Bioeng 2012; 109:2134-46. [PMID: 22331657 DOI: 10.1002/bit.24456] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2011] [Revised: 01/18/2012] [Accepted: 01/26/2012] [Indexed: 01/22/2023]
Abstract
Previously, we showed that macroporous titanium implants, colonized in vivo together with an epithelial graft, are viable options for tracheal replacement in sheep. To decrease the number of operating steps, biomaterial-based replacements for epithelial graft and intramuscular implantation were developed in the present study. Hybrid microporous PLLA/titanium tracheal implants were designed to decrease initial stenosis and provide a surface for epithelialization. They have been implanted in New Zealand white rabbits as tracheal substitutes and compared to intramuscular implantation samples. Moreover, a basement membrane like coating of the implant surface was also designed by Layer-by-Layer (LbL) method with collagen and alginate. The results showed that the commencement of stenosis can be prevented by the microporous PLLA. For determination of the optimum time point of epithelialization after implantation, HPLC analysis of blood samples, C-reactive protein (CRP), and Chromogranin A (CGA) analyses and histology were carried out. Following 3 weeks the implant would be ready for epithelialization with respect to the amount of tissue integration. Calcein-AM labeled epithelial cell seeding showed that after 3 weeks implant surfaces were suitable for their attachment. CRP readings were steady after an initial rise in the first week. Cross-linked collagen/alginate structures show nanofibrillarity and they form uniform films over the implant surfaces without damaging the microporosity of the PLLA body. Human respiratory epithelial cells proliferated and migrated on these surfaces which provided a better alternative to PLLA film surface. In conclusion, collagen/alginate LbL coated hybrid PLLA/titanium implants are viable options for tracheal replacement, together with in situ epithelialization.
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Affiliation(s)
- Nihal Engin Vrana
- Institut National de la Santé et de la Recherche Médicale, INSERM Unité 977, 11 Rue Humann, 67085 Strasbourg, France
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Liu XK, Zhang Q, Li Q, Liu WW, Li H, Zeng ZY, Guo ZM. Laryngeal framework reconstruction using titanium mesh in glottic cancer after frontolateral vertical partial laryngectomy. Laryngoscope 2011; 120:2197-202. [PMID: 20824791 DOI: 10.1002/lary.21103] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES To investigate the feasibility and efficacy of laryngeal framework reconstruction using titanium mesh in patients with glottic cancer after frontolateral vertical partial laryngectomy. STUDY DESIGN Prospective study. METHODS Defect of laryngeal framework, caused by frontolateral vertical partial laryngectomy in nine patients with T2 or T3 squamous cell carcinoma of glottic, were reconstructed with titanium mesh from 2007 to 2009. Computed tomography (CT) and fiberscopic examinations were performed at two weeks and three months postoperatively. RESULTS No aspiration and laryngeal stenosis was observed in the nine patients. CT scanning showed that titanium mesh was fastened well without displacement and deformity and that there was no laryngeal stenosis. Fiberscopic inspection showed that the larynx lumen was maintained well without stricture, shrinkage, and necrosis. No titanium mesh was exposed to the larynx lumen. CONCLUSIONS Titanium mesh was a good alternative for reconstruction of the laryngeal framework. It provided adequate structural support to maintain airway patency.
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Affiliation(s)
- Xue-Kui Liu
- State Key Laboratory of Oncology in South China, Department of Head and Neck Surgery, Cancer Center, Sun Yat-Sen University, Guangzhou, Guangdong, P.R. China
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Naito H, Tojo T, Kimura M, Dohi Y, Zimmermann WH, Eschenhagen T, Taniguchi S. Engineering bioartificial tracheal tissue using hybrid fibroblast-mesenchymal stem cell cultures in collagen hydrogels. Interact Cardiovasc Thorac Surg 2010; 12:156-61. [PMID: 21098511 DOI: 10.1510/icvts.2010.253559] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
We aimed at providing the first in vitro and in vivo proof-of-concept for a novel tracheal tissue engineering technology. We hypothesized that bioartificial trachea (BT) could be generated from fibroblast and collagen hydrogels, mechanically supported by osteogenically-induced mesenchymal stem cells (MSC) in ring-shaped 3D-hydrogel cultures, and applied in an experimental model of rat trachea injury. Tube-shaped tissue was constructed from mixtures of rat fibroblasts and collagen in custom-made casting molds. The tissue was characterized histologically and mechanically. Ring-shaped tissue was constructed from mixtures of rat MSCs and collagen and fused to the tissue-engineered tubes to function as reinforcement. Stiffness of the biological reinforcement was enhanced by induction of osteogeneic differentiation in MSCs. Osteogenic differentiation was evaluated by assessment of osteocalcin (OC) secretion, quantification of calcium (Ca) deposit, and mechanical testing. Finally, BT was implanted to bridge a surgically-induced tracheal defect. A three-layer tubular tissue structure composed of an interconnected network of fibroblasts was constructed. Tissue collapse was prevented by the placement of MSC-containing ring-shaped tissue reinforcement around the tubular constructs. Osteogenic induction resulted in high OC secretion, high Ca deposit, and enhanced construct stiffness. Ultimately, when BT was implanted, recipient rats were able to breathe spontaneously.
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Affiliation(s)
- Hiroshi Naito
- Department of Thoracic and Cardiovascular Surgery, Nara Medical University School of Medicine, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan.
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Martinod E, Seguin A, Radu D, Marquette CH, Carpentier A. Avancées en chirurgie trachéale : a-t-on enfin trouvé le substitut idéal à la trachée ? Rev Mal Respir 2010; 27:554-64. [DOI: 10.1016/j.rmr.2010.04.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2009] [Accepted: 12/21/2009] [Indexed: 12/16/2022]
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Janssen LM, van Osch GJVM, Li JP, Kops N, de Groot K, Feenstra L, Hardillo JAU. Laryngotracheal reconstruction with porous titanium in rabbits: are vascular carriers and mucosal grafts really necessary? J Tissue Eng Regen Med 2010; 4:395-403. [DOI: 10.1002/term.254] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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The effect of microstructured surfaces and laminin-derived peptide coatings on soft tissue interactions with titanium dental implants. Biomaterials 2009; 30:2291-301. [DOI: 10.1016/j.biomaterials.2009.01.004] [Citation(s) in RCA: 107] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2008] [Accepted: 01/03/2009] [Indexed: 11/23/2022]
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Gaafar AA, El-Daly AA, Gaafar HA. Laryngotracheal augmentation using titanium mesh. The Journal of Laryngology & Otology 2007; 122:391-6. [PMID: 17498337 DOI: 10.1017/s0022215107008109] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractBackground:The management of laryngotracheal stenosis is still a serious surgical challenge. The fact that there are currently numerous reconstruction procedures indicates that there is at present no standard treatment.Study design:Titanium mesh was used instead of traditional homografts in reconstruction of the anterior laryngotracheal wall in 12 tracheostomised patients with benign chronic laryngotracheal stenosis. The anterior laryngotracheal wall was split, followed by excision of scar tissue and fixation of the titanium plate at the split end. A Silastic®stent was inserted above the tracheostomy tube and fixed in place by running sutures fixed to the skin by buttons. The stent was removed endoscopically six weeks later and a trial of decannulation was undertaken.Results:Endoscopically, good epithelisation was seen on the inner surface of the mesh in 10 cases and decannulation was possible. Four of these patients required endoscopic debulking of granulation tissue. Decannulation was impossible in two cases, one due to excessive granulation tissue and the other due to prolapse of the titanium mesh into the tracheal lumen (the mesh was removed endoscopically and a Montgomery T-tube inserted).Conclusion:Titanium mesh was found to be a good alternative for augmentation of the anterior laryngotracheal wall. It offered rigid support, with fewer of the complications reported with other grafts.
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Affiliation(s)
- A A Gaafar
- Department of Otolaryngology Head & Neck Surgery, University of Alexandria, Egypt.
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Cheung S, Gauthier M, Lefebvre LP, Dunbar M, Filiaggi M. Fibroblastic interactions with high-porosity Ti-6Al-4V metal foam. J Biomed Mater Res B Appl Biomater 2007; 82:440-9. [PMID: 17245747 DOI: 10.1002/jbm.b.30749] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A novel metallic Ti-6Al-4V foam in development at the National Research Council of Canada was investigated for its ability to foster cell attachment and growth using a fibroblast cell culture model. The foam was manufactured via a powder metallurgical process that could produce interconnected porosity greater than 70%. Cell attachment was assessed after 6 and 24 h, while proliferation was examined after 3 and 7 days. Ingrown fibroblasts displayed a number of different morphologies; some fibroblasts were spread thinly in close apposition with the irregular surface, or more often had several anchorage points and extended in three dimensions as they spanned pore space. It was also demonstrated that fibroblasts were actively migrating through the porous scaffold over a 14-day period. In a 60-day extended culture, fibroblasts were bridging and filling macropores and had extensively infiltrated the foams. Overall, it was established that this foam was supportive of cell attachment and proliferation, migration through the porous network, and that it was capable of sustaining a large cell population.
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Affiliation(s)
- Serene Cheung
- School of Biomedical Engineering, Dalhousie University, 5981 University Avenue, Halifax, Nova Scotia, Canada
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Schultz P, Vautier D, Charpiot A, Lavalle P, Debry C. Development of tracheal prostheses made of porous titanium: a study on sheep. Eur Arch Otorhinolaryngol 2006; 264:433-8. [PMID: 17123095 DOI: 10.1007/s00405-006-0195-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2006] [Accepted: 10/11/2006] [Indexed: 12/14/2022]
Abstract
Authors report the development of a biomaterial to be used for tracheal and laryngeal reconstruction. This experimentation follows the replacement of trachea in rats with porous titanium implants. The aim of the study is to test this type of prosthesis on sheep, whose trachea is of comparable size to that of humans. Six ewes were implanted with porous titanium implants after resection of 5 cm of trachea. The planned period for the implantation was from 3 to 6 months before the sacrifice of the animals for histological analysis. After a simple immediate postoperative course, the implantations developed complications of tracheal patency, responsible for four deaths (tracheal obstruction by mucous plug n = 2, inferior necrosis of trachea n = 1, pneumopathy n = 1). The two remaining sheep presented no complications. The mechanical performance of the prostheses was good. The histological results showed an inflammatory stenosis of the tracheo-prosthetic junctions, which was not the direct result of death. The protheses were integrated by the surrounding tissue, but endoprosthetic colonisation by pseudostratified ciliated columnar epithelium was low or nil. The absence of endoprosthetic lining was responsible for the complications. The biocompatibility of the biomaterial is not in question, but the surgical procedure will have to be modified by an endoprosthetic mucous graft before implantation so as to accelerate healing process.
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Affiliation(s)
- P Schultz
- Department of Otorhinolaryngology and Technical Research Team, CHU Hautepierre and ERT 10-61, Strasbourg Cedex, France.
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Schultz P, Vautier D, Richert L, Jessel N, Haikel Y, Schaaf P, Voegel JC, Ogier J, Debry C. Polyelectrolyte multilayers functionalized by a synthetic analogue of an anti-inflammatory peptide, α-MSH, for coating a tracheal prosthesis. Biomaterials 2005; 26:2621-30. [PMID: 15585265 DOI: 10.1016/j.biomaterials.2004.06.049] [Citation(s) in RCA: 101] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2004] [Accepted: 06/25/2004] [Indexed: 11/22/2022]
Abstract
Polyelectrolyte multilayer films made of poly (L-lysine) (PLL) and poly (L-glutamic acid) (PGA) have been functionalized by covalent binding of a synthetic analogue of the anti-inflammatory peptide, alpha-melanocyte-stimulating hormone (alpha-MSH) to PGA to create biologically active coatings for tracheal prostheses. The morphology and in vivo stability of the films were investigated by atomic force microscopy and confocal laser scanning microscopy, respectively. For the in vivo evaluation, 87 rats were implanted and examined for a period superior to 3 months. Histological analysis, performed 1 month after implantation, showed a fibroblast colonization of the periprosthetic side and a respiratory epithelium type on the endoluminal side of the implant for all the polyelectrolyte coatings tested. However, for prostheses modified by PGA ending multilayer films, a more regular and less obstructive cell layer was observed on the endoluminal side compared to those modified by PLL ending films. Systemic anti-inflammatory IL-10 production was only detected in rats implanted with prostheses functionalized by alpha-MSH, demonstrating, in vivo, the anti-inflammatory activity of the embedded peptide into multilayer architectures.
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Affiliation(s)
- Philippe Schultz
- Department of Otolaryngology-Head and Neck Surgery, Hautepierre Hospital, Strasbourg, France
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ten Hallers EJO, Rakhorst G, Marres HAM, Jansen JA, van Kooten TG, Schutte HK, van Loon JP, van der Houwen EB, Verkerke GJ. Animal models for tracheal research. Biomaterials 2004; 25:1533-43. [PMID: 14697856 DOI: 10.1016/s0142-9612(03)00500-3] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Tracheal research covers two main areas of interest: tracheal reconstruction and tracheal fixation. Tracheal reconstructions are aimed at rearranging or replacing parts of the tracheal tissue using implantation and transplantation techniques. The indications for tracheal reconstruction are numerous: obstructing tracheal tumors, trauma, post-intubation tissue reactions, etc. Although in the past years much progress has been made, none of the new developed techniques have resulted in clinical application at large scale. Tissue engineering is believed to be the technique to provide a solution for reconstruction of tracheal defects. Although developing functional tracheal tissue from different cultured cell types is still a challenge. Tracheal fixation research is relatively new in the field and concentrates on solving fixation-related problems for laryngectomized patients. In prosthetic voice rehabilitation tracheo-esophageal silicon rubber speech valves and tracheostoma valves are used. This is often accompanied by many complications. The animal models used for tracheal research vary widely and in most publications proper scientific arguments for animal selection are never mentioned. It showed that the choice on animal models is a multi-factorial process in which non-scientific arguments tend to play a key role. The aim of this study is to provide biomaterials scientists with information about tracheal research and the animal models used.
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Affiliation(s)
- E J O ten Hallers
- Faculty of Medicine, Department of BioMedical Engineering, University of Groningen, P.O. Box 196, Groningen, 9700, The Netherlands
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Schultz P, Vautier D, Egles C, Debry C. Experimental study of a porous rat tracheal prosthesis made of T40: long-term survival analysis. Eur Arch Otorhinolaryngol 2003; 261:484-8. [PMID: 14655018 DOI: 10.1007/s00405-003-0717-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2003] [Accepted: 10/20/2003] [Indexed: 10/26/2022]
Abstract
In order to repair large defects in the laryngotracheal area, we developed a biomaterial based on porous titanium (Ti40) formed of spherical particles that are welded together. These Ti40 beads were arranged in several layers to create the rat tracheal prosthesis. After a partial tracheal resection, the prosthesis was fixed to both extremities to replace the missing part. Tissue surrounding the prosthesis was collected from 33 surviving animals after an implantation period of 3 to 12 months. Histological analyses showed that the periphery of the prosthesis was covered with fibroblasts and a few lymphocytes that penetrated the titanium layers. A ciliary cylindrical epithelium of respiratory type was found on the endoluminal side. The inflammatory reaction observed was minimal. These data indicate that the prosthesis, implanted in a laryngotracheal environment, is well tolerated by animals. Our results represent the first step towards the construction of a total laryngeal prosthesis that should allow restoration of the essential functions of the larynx after a laryngectomy in cancer treatment.
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Affiliation(s)
- P Schultz
- Department of Otorhinoaryngology, CHU Hautepierre, avenue Molière, 67098, Strasbourg, France.
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