Liu Xin, Jiang Zhao-yang, Qin Yong
Department of Otorhinolaryngology Head and Neck Surgery, Peking University First Hospital, Beijing 100034, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2010 Aug;45(8):669-73.
The Carbon fiber reinforced carbon matrix composites were employed for reconstruction of large circumferential defect of the cervical trachea. The biocompatibility and biofunctionality of the new type carbonaceous tracheal prosthesis were evaluated, and the feasibility for cervical tracheal reconstruction discussed.
Two types of carbonaceous tracheal prosthesis with different weaving methods of carbon fiber were used on eight healthy canines. Three to six tracheal cartilage rings were resected circumferentially. The 2 cm long tracheal prosthesis was transplanted into canines and the anastomosis was completed by end-to-end, tracheal-into-prosthesis and prosthesis-into-tracheal method. The function of breathing, eating and infection was observed after surgery. Four months later, the five survival canines were sacrificed and the prosthesis with surrounding tissues was removed for observation by optical microscopy and scanning electron microscopy.
All dogs had cough symptom in different degree lasted 1 - 4 weeks after surgery. Two dogs with tracheal-into-prosthesis anastomosis showed eating disorders in different degree. One canine died due to airway obstruction caused by dislocation of prosthesis within three weeks after operation. Another two deaths in 11th week and 12th week were attributed to suffocation because of hypergranulation and scar formation. Prosthesis was surrounded by connective tissues and anchored firmly to the neighboring tissues. Most part of the luminal surface of tracheal prosthesis was not covered by respiratory mucosa. However, the inner layer showed scant re-epithelialization beyond the anastomosis.
The implantation of the carbonaceous tracheal prosthesis can maintain the normal respiratory function of the experimental canines, but hypergranulation and scar formation around the end of the tracheal prosthesis and epithelium on the luminal surface of the prosthesis are questions still remained to be solved.
采用碳纤维增强碳基复合材料重建颈段气管大段环形缺损。评估新型含碳气管假体的生物相容性和生物功能性，并探讨颈段气管重建的可行性。
将两种碳纤维编织方式不同的含碳气管假体应用于8只健康犬。环形切除3至6个气管软骨环。将2厘米长的气管假体植入犬体内，采用端端吻合、气管-假体吻合和假体-气管吻合方法完成吻合。术后观察呼吸、进食和感染情况。4个月后，处死5只存活犬，取出带有周围组织的假体，进行光学显微镜和扫描电子显微镜观察。
所有犬术后均有不同程度咳嗽症状，持续1至4周。2只采用气管-假体吻合的犬有不同程度进食障碍。1只犬术后3周因假体脱位导致气道梗阻死亡。另外2只分别于第11周和第12周因肉芽组织增生和瘢痕形成导致窒息死亡。假体被结缔组织包绕，与相邻组织牢固固定。气管假体管腔表面大部分未被呼吸黏膜覆盖。然而，吻合口以外的内层有少量再上皮化。
含碳气管假体植入可维持实验犬的正常呼吸功能，但气管假体末端周围肉芽组织增生和瘢痕形成以及假体管腔表面上皮化问题仍有待解决。
