Tracheal reconstruction using alcohol-stored homologous cartilage and autologous cartilage in the rabbit model

Objective: Reconstruction of laryngotracheal stenosis continues to pose a s ignificant challenge. Cartilage grafts have been in use for almost a centur y, but despite good clinical results, many questions concerning the surviva l and growth of implanted cartilage persist. To reduce donor site morbidity , the use of homologous cartilage has been investigated. This study compare d alcohol-stored homologous auricular cartilage with autologous auricular c artilage for anterior graft laryngotracheal reconstruction in a rabbit mode l, Methods: Autologous and alcohol preserved homologous auricular cartilage was transplanted to the resected anterior tracheal wall of the twenty New Zealand rabbits. Rabbits were sacrificed 6 weeks after surgery and histolog ic analysis was performed on the implanted cartilage grafts. Results: The a utografts were significantly more likely than the homografts to demonstrate Viable cells (95% vs. 30%, P < 0.05) and less likely to exhibit significan t resorption, fibrosis or necrosis (P < 0.05). Resorption and necrosis were most common in areas of trauma to the graft. Complete epithelialization oc curred in all of the autografts but in only 65% of the homografts (P < 0.05 ). New cartilage formation and integration of the implanted grafts was poor with both types of grafts. Conclusion: Autologous cartilage appears to hav e better survival than alcohol preserved homologous cartilage when used for anterior graft laryngotracheal reconstruction in a rabbit model. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.