Laryngotracheal Stenosis Repair Using Cartilage-Derived Morphogenic Proteins: A Pilot Study

Abstract

Objectives: This pilot study evaluated the role of cartilage-derived morphogenic proteins (CDMPs) as promoters of cartilage growth and differentiation and as a possible alternative to autologous cartilage grafts in laryngotracheal reconstruction. Methods: In phase 1, 6 New Zealand rabbits underwent subperichondrial injection of CDMP-1, CDMP-2, or CDMP-3 in the right thyroid ala and normal saline solution in the left thyroid ala as controls. In phase 2, 14 rabbits underwent anterior cricoid split and interposition of a fibrillar collagen sponge saturated with normal saline solution, CDMP-2, or CDMP-3. Results: In both phases, saline solution failed to induce new cartilage or bone growth. Small foci of cartilage and/or bone formation were observed within the thyroid subperichondria of those rabbits injected with CDMP-2 or CDMP-3. In phase 2, a few small foci of new cartilage and/or bone formation were observed at the edges of the cricoid split with CDMP-2 and CDMP-3. Conclusions: A different carrier of CDMP, a change in dosage, or a combination of CDMPs might yield more significant neochondrification. The role of CDMPs as promoters of cartilage and differentiation could not be disqualified in this study and should be further investigated.