Platelet-rich plasma for laryngotracheal reconstruction: an experimental study
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LARYNGOLOGY
Platelet‑rich plasma for laryngotracheal reconstruction: an experimental study Serap Sahin Onder1 · Asli Sahin Yilmaz1 · Burak Erkmen1 · Cumhur Selçuk Topal2 · Ozgul Gergin3 · Mustafa Salih Canpolat4 Received: 15 April 2020 / Accepted: 26 May 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Objectives/hypothesis This study was designed to evaluate the graft healing effect of topical application of platelet-rich plasma (PRP) for laryngotracheal reconstruction (LTR) in a rabbit model. Study design It is a prospective randomized control animal study. Materials and methods Sixteen healthy New Zealand White rabbits were assigned to two groups of eight animals each. The control group underwent LTR with anterior auricular cartilage graft. The PRP group underwent the same surgical procedure plus PRP application over the anastomosis and surgical field. Two animals in the PRP group and two animals in control group died due to severe respiratory distress on postoperative days 10, 12, 15, and 18. Six rabbits (n = 3 for control group and n = 3 for PRP group) were sacrificed at 4 weeks, and six rabbits (n = 3 for control group and n = 3 for PRP group) were sacrificed at 8 weeks. Laryngotracheal regions were evaluated histopathologically. Results Macroscopically, the average anteroposterior and lateral diameter of the reconstructed region and the degree of lumen patency on postoperative 4th week and 8th week were not statistically different among two groups. There was no significant difference between the groups in terms of any of the microscopic findings when the analysis was made separately. However, analysis of the total number of rabbits has shown that new cartilage formation and angiogenesis were more pronounced in PRP group than control group. Conclusions Application of PRP contributed to better healing in airway surgery by promoting a release of growth factors that stimulate new cartilage formation and angiogenesis. Keywords Platelet-rich plasma · Laryngotracheal reconstruction · Wound healing
Introduction
* Serap Sahin Onder [email protected] 1
Department of Otolaryngology, Umraniye Research and Education Hospital, University of Health Sciences, Elmalıkent Mahallesi Adem Yavuz Caddesi, Umraniye, 34764 Istanbul, Turkey
2
Department of Pathology and Molecular Medicine, Umraniye Research and Education Hospital, University of Health Sciences, Istanbul, Turkey
3
Department of Otolaryngology, Medipol International Health Center Camlıca Hospital, Istanbul, Turkey
4
Department of Otolaryngology, Uskudar Hospitalturk Hospital, Istanbul, Turkey
Laryngotracheal stenosis (LTS) is characterized by significant narrowing of airway leading to airway obstruction. Causes of LTS include congenital or acquired factors and autoimmune disorders [1]. Acquired stenosis secondary to prolonged endotracheal intubation is observed in of 0, 24% of the neonatal population. The overall incidence of subglottic stenosis following intubation in the pediatric population is unknown [
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