Cartilage graft epithelialization. A preliminary study using a goat model.

Abstract

OBJECTIVE: To determine if the presence of a laryngeal stent adversely affects the epithelialization of an anterior costal cartilage graft. DESIGN: Twelve goats underwent laryngotracheoplasty using an anterior costal cartilage graft. No stent was used in six animals, and a modified endotracheal tube stent was used in the other six. The degree of epithelialization in each group was compared histologically, as well as other histologic criteria (epithelial metaplasia, cilia formation, and inflammatory cell infiltration). SETTING: Children's Hospital Medical Center of Cincinnati (Ohio) Medical Research Building. PATIENTS AND OTHER PARTICIPANTS: No human subjects were used in this study. MAIN OUTCOME MEASURES: Qualitative histologic analysis of cartilage graft epithelialization, epithelial metaplasia, cilia formation, and inflammatory cell infiltration was performed. The stent vs no-stent groups were compared histologically. RESULTS: In the stented group, one cartilage graft extruded, while five remained in place. All of the no-stent cartilage grafts remained in place. A trend was observed in the no-stent group toward increased cartilage graft epithelialization and cilia formation, while there was a decrease in epithelial metaplasia and infiltration by inflammatory cells. CONCLUSIONS: Although the study population was small, the presence of a laryngeal stent tended to predispose the graft to increased inflammation and epithelial metaplasia and may adversely affect cartilage graft epithelialization. The goat may be an adequate animal model for laryngotracheal reconstruction and, possibly, subglottic stenosis.