Tracheal Reconstruction with Perichondrial Graft - An Experimental Study - |
Won Sang Lee, MD1, Jang Su Suh, MD1, Sung Eun Yi, MD1, In Young Park, MD1, Won Pyo Hong, MD1, Chan Il Park, MD2, and Hogeun Kim, MD2 |
1;Department of Otolaryngology, 2;Pathology, College of Medicine, Yonsei University, Seoul, Korea |
연골 피막편 이식후 기관결손 부위의 재생에 관한 실험적 연구 |
이원상1 · 서장수1 · 이성은1 · 박인용1 · 홍원표1 · 박찬일2 · 김호근2 |
연세대학교 의과대학 이비인후과학교실1;병리학교실2; |
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ABSTRACT |
Recently through the advancement of medical and surgical management and the development of low pressure cuffed endotracheal tube, incidence of tracheal stenosis has been decreased significantly. Though its incidence was decreased markedly, stenosis developes unfortunately in the situations such as long term use of respirator, severe infection and trauma of trachea, etc. Tracheal stenosis had been handled with various methods such as mechanical dilatation, tissue graft technique, luminal augmentation and end to end anastomosis due to their individual advantages but their effect were not satisfactory. In 1959 Lester found the regeneration of cartilage from the perichondrium of the rib cartilage. Since then Skoog (1972), Sohn (1974), and Ohlsen (1976) reported chondrogenic potential of perichondrium through the animal experiments. Though many different materials have been tried to correct stenosis and repair the defect of the trachea, tracheal reconstruction has been a perplexing clinical problem. Authors choose the perichondrium as the graft material because the cartilage itself is the normal supporting matrix of the structure and it will be an obvious advantage to be able to position perichondrium over the defect and obtain new cartilage there. On the purpose of repairing tracheal defect, authors used two different graft methods and the young rabbits, which were selected as experimental animals, were sacrificed from two to eight weeks after surgery. One group was grafted with free perichondrium and its endochondral surface was toward to the tracheal lumen. The other group was vise versa. Through the experiment it was confirmed that perichondrium was the suitable material for the reconstruction of the tracheal defect.
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