A recent
study raises the possibility of treating damaged laryngeal cartilage by
replacing it with a cartilage scaffold.
The paired arytenoid cartilages of the larynx provide
attachment for the vocal folds and together they serve to open and close the airway.
Chondritis or chondropathy is a condition of the arytenoid cartilage,
seen especially in young Thoroughbreds. It may result in abscess formation with
granulation tissue protruding into the lumen of the airway. Severe cases may
result in deformity and dysfunction.
If medical treatment is unsuccessful the affected cartilage
can be removed. But this is not without risk of complications such as inhalation
of food material and dynamic collapse of the soft tissue surrounding the larynx
during exercise.
The possibility of using a cartilage scaffold to replace the
defect was investigated in a study published in
the journal Tissue Engineering (Part A).
Dr Marta Cercone and colleagues report the use of an acellular
cartilage scaffold, which was produced by treating the cartilage to remove the cells, leaving just the cartilage matrix.
These scaffolds were then implanted into full-thickness
defects in both arytenoid cartilages of eight horses. Before implantation, one
of the two implants for each horse was seeded with bone marrow-derived
nucleated cells (BMNC) collected from each recipient.
The research team found that, two months after the procedure,
mucosal epithelium had grown across the surface of the implant and the
cartilage had become integrated into the recipient’s arytenoid cartilage. They detected
minimal adverse cellular reaction.
They report that pre-seeding the scaffold with BMNC
increased the rate at which the scaffold was broken down and incorporated into
the recipient cartilage.
They conclude that replacing a portion of the arytenoid
cartilage with a tissue engineered cartilaginous graft pre-seeded with BMNC is
surgically feasible in the horse. The procedure is “well tolerated, results in
appropriate integration within the native tissue and prevented laryngeal
collapse during exercise.”
For more details, see:
An exploratory
study into the implantation of arytenoid cartilage scaffold in the Horse
Marta
Cercone, Bryan Brown, Elizabeth C Stahl, Lisa M Mitchell, Lisa Fortier, Hussni
O Mohammed, Norm G Ducharme
Tissue Eng
Part A (2020)
