Autogenous Mucosa-Lined Tracheal Prosthesis / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Reliable prosthetic or tissue graft of trachea for reconstruction of large, circumferential tracheal defect has not yet been developed. The major limitations in this area have been anastomotic dehiscence and stenosis, which are attributed to poor epithelialization and vascularization of prosthetic grafts. MATERIALS AND METHOD: We developed a new tracheal prosthesis which has a viable lined mucosa and is well-vascularized. The prosthesis consists of Prolene mesh reinforced with polypropylene rings, and is coated with gelatin. We lined the luminal surface of the prosthesis with transplanted autogenous oral mucosa and wrapped the prosthesis with greater omentum. Animal experiments were performed using 8 adult Mongrel dogs. RESULTS: The transplanted mucosa and the greater omentum that was wrapped were tightly adhered to the prosthesis to make a single unit within two weeks. The mucosa survived well, having been vascularized by new vessels from the greater omentum, and showed normal histology. CONCLUSION: We concluded that this highly biocompatible tracheal prosthesis could be very useful for stage4 reconstruction of tracheal defects.

The Vocal Fold Augmentation with Liposuctioned Autologous Fat / 대한이비인후과학회지

BACKGROUND: We experienced 11 cases of hoarseness and aspiration caused by vocal cord palsy or volume deficit. There are many materials used for injection into vocal cords to relieve hoarseness and aspiration (paraffin, gel foam, teflon, etc.). But, these materials can cause tissue reaction. Recently, many authors reported successful results by the injection laryngoplasty with autologous fat. And we discuss the effectiveness and complications of the injection thyroplasty with autologous fat. MATERIALS AND METHODS: We injected lipo-suctioned autologous fat into vocal cords with our method, and observed the effectiveness and complications of that method for more than 6 months. We analyzed hoarseness score and aspiration score and performed the acoustic analysis of speech. RESULTS: We found only little improvement in the cases of sulcus vocalis, but good short-term results in the cases of vocal cord palsy. We observed no significant complications. CONCLUSION: The injection thyroplasty with autologous fat is a safe, efficacious, economical and well-tolerated intervention for vocal cord palsy patients, who have possible reversibility of palsy, to relieve hoarseness and aspiration for short term.