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Sarvi Nalwa ‘01
Nalwa S, Hartig G, Warner T, Connor NP, Thielman M. Evaluation of poly-L-glycolic
acid resorbable stents for repair of tracheomalacia in a porcine model.
Ann Otol Rhinol Laryngol 2001; 110:993-999
Poly-L-lactic
acid and poly-glycolic acid (PLPG) resorbable stents may offer a potential
solution to the problem of tracheomalacia. Advantages of this material
include its strength, its versatile shaping characteristics, and its resorbability,
which would preclude surgical removal and allow for airway growth. The
purpose of this pilot study was to examine the usefulness of PLPG stents
for temporary external airway stenting of tracheomalacia in a porcine
model. A severe tracheomalacia was created in 6 pigs by submucosal resection
of segments of tracheal cartilage from 6 consecutive rings. The PLPG stent
was then shaped to recreate the tracheal contour and sutured to the underlying
airway. Endoscopic photodocumentation during spontaneous ventilation was
obtained before and after reconstruction. After creation of the malacic
tracheal segment, all animals developed stridor, retractions, and cyanosis
during spontaneous ventilation. After repair, all animals were extubated
without complication. All animals survived the follow-up period of 9 to
12 weeks without evidence of respiratory distress and with rapid weight
gain. Repeat bronchoscopy showed no evidence of airway collapse during
spontaneous ventilation. Tracheal measurements revealed growth of the
stented segment with a mild narrowing within the repaired region. Histologic
examination showed preservation of respiratory epithelium. These preliminary
findings suggest that PLPG stents may serve a useful role in the surgical
management of tracheomalacia.
Figure: Trachea with resorbable stent in place.
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First published: 07/15/02 Last updated: 11/24/09
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