Tracheoplasty for congenital complete tracheal rings: Andrews T.M.; Cotton R.T.; Bailey W.W.; Myer C.M. III; Vester S.R.Arch. Otolaryngol. Head Neck Surg. (USA) (1994) 120/12 (1363–1369)

Abstract

This chapter presents an overview of regenerative medicine of the respiratory tract. Olfactory ensheathing cells are a class of glial cells, which support regeneration of olfactory receptor neurons in the olfactory epithelium. When transplanted to other regions of the brain they may support regeneration of other classes of neurons. They also support axon regeneration and are successfully employed in rat models of spinal cord regeneration. Human nasal septum is a good source of chondrogenic cells with the potential to be used to engineer transplants for restorative surgery in otolaryngology. Partial laryngeal reconstruction is required for stenosis in children and adults and after resection of carcinomas in adults. Conventional means of restoring subglottic lumen include endoscopic techniques, which need repeating, large segmental resections, or the insertion of rib cartilage grafts. The synthetic or biological scaffolds may form the basis for myoblast progenitor cell proliferation and differentiation. The use of dynamic bioreactor “preconditioning” causes fiber-type differentiation into the appropriate MyHC subtypes (slow versus various forms of fast fibers) and, crucially, orientation of myotubes. The only curative treatment of any tracheal lesions involving less than 50% of the total length of the trachea is achieved by segmental resection followed by tracheal mobilization and primary end-to-end anastomosis in adults and/or slide tracheoplasty in children with long-segment tracheal stenosis.