CARTILAGE GRAFT EPITHELIALIZATION - A PRELIMINARY-STUDY USING A GOAT MODEL

Objective.-To determine if the presence of a laryngeal stent adversely affects the epithelialization of an anterior costal cartilage graft. Design.-Twelve goats underwent laryngotracheoplasty using an anterior costal cartilage graft. No stent was used in six animals, and a modifi ed endotracheal tube stent was used in the other six. The degree of ep ithelialization in each group was compared histologically, as well as other histologic criteria (epithelial metaplasia, cilia formation, and inflammatory cell infiltration). Setting.-Children's Hospital Medical Center of Cincinnati (Ohio) Medical Research Building. Patients and O ther Participants.-No human subjects were used in this study. Main Out come Measures.-Qualitative histologic analysis of cartilage graft epit helialization, epithelial metaplasia, cilia formation, and inflammator y cell infiltration was performed. The stent vs no-stent groups were c ompared histologically. Results.-In the stented group, one cartilage g raft extruded, while five remained in place. All of the no-stent carti lage grafts remained in place. A trend was observed in the no-stent gr oup toward increased cartilage graft epithelialization and cilia forma tion, while there was a decrease in epithelial metaplasia and infiltra tion by inflammatory cells. Conclusions.-Although the study population was small, the presence of a laryngeal stent tended to predispose the graft to increased inflammation and epithelial metaplasia and may adv ersely affect cartilage graft epithelialization. The goat may be an ad equate animal model for laryngotracheal reconstruction and, possibly, subglottic stenosis.