Chapter 47 - Tissue Engineering of Larynx

Abstract

Laryngeal tissue engineering is an exciting field that has the potential of impacting millions of lives. Given the specialized structures and functions of the larynx, tissue bioengineering of this organ is met with many challenges. Current techniques are focused on restoration of vocal fold pliability, providing structural integrity, and neuromuscular regeneration. Investigations into vocal fold regeneration have resulted in a variety of options that are primarily oriented around injectable substances. Hyaluronic acid-based hydrogels, mesenchymal stem cells, and growth factors have all shown promise in the restoration of normal vocal fold biomechanics. Recently, a decellularized human larynx scaffold was successfully created, and may serve as the foundation for hemilaryngectomy defect reconstruction with regenerative tissue. Neuromuscular regeneration continues to be a challenge, but is essential to restoration of normal laryngeal function. Nerve conduits supplemented with neurotrophic factors have allowed for improved neural regeneration. However, aberrant reinnervation of laryngeal musculature prohibits fine vocal fold muscle control. Although laryngeal tissue engineering is still in its infancy, many significant achievements have occurred that advance our understanding of the complex laryngeal functions and bring us one step closer to clinical implementation.