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Airway Reconstruction With Carrier‐Free Cell Sheets Composed of Autologous Nasal Squamous Epithelium
Author(s) -
Koo Jaseok P.,
Kim ChangHoon,
Lee JeungGweon,
Kim KyungSu,
Yoon JooHeon
Publication year - 2007
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/mlg.0b013e3180f62b78
Subject(s) - epithelium , respiratory epithelium , medicine , airway , in vivo , nose , pathology , mucus , stratified squamous epithelium , cell , anatomy , surgery , biology , ecology , genetics , microbiology and biotechnology
Objectives/Hypothesis: Although skin has been the most effective graft material for reconstructing the airway lumen, the use of squamous epithelium has many problems. If autologous airway squamous epithelium could differentiate into mucociliary epithelium after in vivo grafting, it could be an answer to these problems. In this study, we wanted to examine whether carrier‐free nasal epithelial cell sheets composed of autologous squamous epithelium could be used as a substitute for skin in airway luminal reconstruction in three maxillectomy patients. Study Design: In vitro biochemical experiments with in vivo applications. Methods: We cultured nasal squamous epithelium from three maxillary cancer patients prior to maxillecotmy. These squamous cell sheets were grafted on the forearm free flap, and, after maxillectomy, the surgical defect was reconstructed with a prefabricated myocutaneous radial forearm free flap with the cultured nasal squamous epithelium. At 1 and 3 month intervals after the reconstructive surgery, the cultured cell grafted area was investigated with histologic phenotype, comparing the skin grafted area. Results: The autologous nasal squamous epithelial cell sheet differentiated into mucociliary epithelium without the crust or mucus stagnation that is usually observed in cases in which skin graft is used for airway reconstruction. Conclusions: We suggest that autologous cultured nasal squamous epithelium, which differentiates into mucociliary epithelium after in vivo grafting, can be used as a clinically relevant substitute for skin graft in airway luminal reconstruction.