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Chirurgie 18. Juni 2013

Applications of tissue engineering in modern laryngology

Background: Tissue Engineering is a multidimensional approach that aims to produce a structure similar to target tissue. Main targets in laryngeal tissue engineering (TE) are chronic vocal fold scars and vocal fold atrophy which occurs in elderly patients. The main obstacle for restoration is the highly complex architecture of the human vocal fold. Deterioration of its micro-architecture leads to altered vibration characteristics that have deleterious effects on voice quality, causing hoarseness (dysphonia). The aim of this study is to give an actual clinical and experimental overview of this field as well as to further elucidate promising new findings and trends.

Methods. We performed a PubMed survey on articles relevant to this field.

Results: Fifty relevant articles were included that reflect the latest advances with growth factors, cell therapy and scaffold engineering, as well the first applications in humans. Cell therapy, using somatic or stem cells, remains highly promising; however, there is a lack of applications in humans due to safety concerns. Different types of scaffolds have been investigated and atelocollagen sheets were already implanted in human vocal folds. Many trials used a combined approach of cell therapy, scaffolds, and different growth factors.

Conclusions. Experiments and trials in laryngeal tissue engineering have emerged over the last decades and clinical use is near. Within this review, we discuss the latest developments to encourage further research on this fascinating topic. Similar to other fields, a close cooperation between different professions such as physicians, bioengineers, as well as industrial partners is required to succeed in laryngeal TE.

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