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Larynx Transplant

Anil Gungor, Lindsey Pennington, Senthil Sankararaman, Samer Zaid-Kaylani, Majed Aldin Jeroudi
Nasal type extranodal natural killer/T-cell lymphoma (ENKTL) is a rare lymphoma in the USA and Europe but endemic in East Asia and in areas of South and Central America. Clinically natural killer cell lymphomas are divided into three categories; nasal, non-nasal and aggressive lymphoma/leukemia subtypes. ENKTL, nasal type occurs in the nose and can extend to the upper aero-digestive tract as reported in this longitudinal case study. This is a longitudinal report of progress of a 14-year-old boy with ENKTL originating in the nasal cavity with subsequent extension and recurrence in the contralateral nose, nasopharynx, larynx and trachea presenting with varying degrees of respiratory problems and eventually, respiratory distress...
August 12, 2016: American Journal of Otolaryngology
Allison F O'Neill, Eelam A Adil, Alexandria L Irace, Laura Neff, Ian J Davis, Antonio R Perez-Atayde, Stephan D Voss, Olga Weinberg, Reza Rahbar
OBJECTIVE: Post-transplant lymphoproliferative disorder (PTLD) is a rare complication of immunosuppression with little consensus on its evaluation and management. The purpose of this contemporary review is to describe a pediatric patient with PTLD of the airway and review the literature to provide multidisciplinary recommendations regarding management. DATA SOURCES: Retrospective chart and literature review. REVIEW METHODS: A pediatric patient with PTLD of the airway is described...
July 2016: International Journal of Pediatric Otorhinolaryngology
Christopher Johnson, Priyanka Sheshadri, Jessica M Ketchum, Lokesh K Narayanan, Paul M Weinberger, Rohan A Shirwaiker
Infection or damage to the trachea, a thin walled and cartilage reinforced conduit that connects the pharynx and larynx to the lungs, leads to serious respiratory medical conditions which can often prove fatal. Current clinical strategies for complex tracheal reconstruction are of limited availability and efficacy, but tissue engineering and regenerative medicine approaches may provide viable alternatives. In this study, we have developed a new "hybrid graft" approach that utilizes decellularized tracheal tissue along with a resorbable polymer scaffold, and holds promise for potential clinical applications...
June 2016: Journal of the Mechanical Behavior of Biomedical Materials
Alberto Bonetta, Laura Bandera, Giandomenico Roviello, Ines Cafaro, Alberto Bottini, Daniele Generali
The oncological treatment for advanced stage head and neck cancer is based on a combination of cisplatin and cetuximab, and radiotherapy. However, very few data are available on this multimodal approach for this type of cancer in pancreas and renal recipients. We report the case of a pancreas and renal recipient being treated with combined chemoradiotherapy for a locally advanced squamous cancer of the larynx. The patient was under treatment with ciclosporin-based immunosuppressive therapy at the time of cancer diagnosis, which was then replaced by everolimus...
June 2016: Anti-cancer Drugs
Nicola Williams
In recent years much research has been undertaken regarding the feasibility of the human uterine transplant (UTx) as a treatment for absolute uterine factor infertility (AUFI). Should it reach clinical application this procedure would allow such individuals what is often a much-desired opportunity to become not only social mothers (via adoption or traditional surrogacy arrangements), or genetic and social mothers (through gestational surrogacy) but mothers in a social, genetic and gestational sense. Like many experimental transplantation procedures such as face, hand, corneal and larynx transplants, UTx as a therapeutic option falls firmly into the camp of the quality of life (QOL) transplant, undertaken with the aim, not to save a life, but to enrich one...
July 2016: Bioethics
Zurab Kakabadze, Konstantine Mardaleishvili, George Loladze, Ivane Javakhishvili, Konstantine Chakhunasvili, Lika Karalashvili, Natia Sukhitashvili, Gocha Chutkerashvili, Ann Kakabadze, David Chakhunasvili
BACKGROUND AND OBJECTIVES: Squamous cell carcinoma is the most common pathological type among the cancers of the larynx. Standard treatment for squamous cell carcinoma of the larynx is the combination of chemotherapy, radiotherapy, and laryngectomy. Pharyngocutaneous fistula is a common complication of laryngectomy. We hypothesized that decellularized and lyophilized human amnion/chorion membrane can be an effective, non-invasive method of treating pharyngocutaneous fistula. METHODS: A total of 67 patients with laryngeal squamous cell carcinoma were retrospectively analyzed after treatment in a prospective trial...
April 2016: Journal of Surgical Oncology
Maria Siemionow
Over the past 20 years, the fields of biomaterial sciences and tissue engineering have evolved into new clinically relevant applications including regenerative medicine and cell based therapies. Tissue engineering therapies are based on different types of materials and scaffolds combined with cells and submitted to engineering processes in order to create bio-scaffolds which will improve or replace biological functions. Despite the effort, only a few therapies, such as bone, cartilage and nerve, succeeded in clinical applications...
December 2015: Journal of Materials Science. Materials in Medicine
Pierluca Piselli, Patrizia Burra, Augusto Lauro, Umberto Baccarani, Giuseppe M Ettorre, Giovanni B Vizzini, Maria Rendina, Massimo Rossi, Giuseppe Tisone, Fausto Zamboni, Ilaria Bortoluzzi, Antonio D Pinna, Andrea Risaliti, Laura Galatioto, Giovanni Vennarecci, Alfredo Di Leo, Francesco Nudo, Daniele Sforza, Giovanni Fantola, Claudia Cimaglia, Diana Verdirosi, Saverio Virdone, Diego Serraino
This study quantified the risk of head and neck (HN) and esophageal cancers in 2770 Italian liver transplant (LT) recipients. A total of 186 post-transplant cancers were diagnosed-including 32 cases of HN cancers and nine cases of esophageal carcinoma. The 10-year cumulative risk for HN and esophageal carcinoma was 2.59%. Overall, HN cancers were nearly fivefold more frequent in LT recipients than expected (standardized incidence ratios - SIR=4.7, 95% CI: 3.2-6.6), while esophageal carcinoma was ninefold more frequent (SIR=9...
July 2015: Transplant International: Official Journal of the European Society for Organ Transplantation
N Scott Howard, Abie H Mendelsohn, Gerald S Berke
OBJECTIVES/HYPOTHESIS: The direct study of human phonation is limited by the invasive and painful nature of human laryngeal neuromuscular manipulation. As a platform for the study of human phonation, indirect models have been utilized for decades such as animal, cadaveric, and computational. We sought to develop a research method allowing direct scientific control of virtually living larynges to expand our ability to understand human phonation. STUDY DESIGN: Canine and porcine models...
June 2015: Laryngoscope
Olivier Fain, Arsène Mekinian, Delphine Gobert, Cam-Anh Khau, Nicolas Javaud
Angiotensin Converting Enzyme inhibitors (ACE-I) use is a frequent cause of AE and must be suspected systematically in all patients with AE. The risk of AE is increased in: black people, transplanted patients, those who take gliptins or immunosuppressants (mTOR i). Angiotensin converting enzyme inhibitors induced angioedema (ACE-I AE) can occur a few days to several years after the beginning of this treatment and persist a few months after stopping it. ACE-I AE affect mainly the face and particularly the tongue but also the abdomen...
January 2015: La Presse Médicale
David G Lott, Jeffrey R Janus
Tissue regeneration in otorhinolaryngology-head and neck surgery is a diverse area filled with specialized tissues and functions. Head and neck structures govern many of the 5 senses, swallowing, breathing, communication, facial animation, and aesthetics. Loss of these functions can have a severe negative effect on patient quality of life. Regenerative medicine techniques have the potential to restore these functions while minimizing the risks associated with traditional reconstruction techniques. This article serves as a review and update on some of the regenerative medicine research in this field...
December 2014: Mayo Clinic Proceedings
Hyun Kyo Jo, Jang Wan Park, Jae Ha Hwang, Kwang Seog Kim, Sam Yong Lee, Jun Ho Shin
BACKGROUND: Laryngeal allotransplantation (LA) is a technique involving transplantation of a deceased donor's larynx into a recipient, and it may be substituted for conventional laryngeal reconstruction. There are widely different views on LA, as the recipient is administered continuous, potentially life-threatening, immunosuppressive therapy for a functional or aesthetic result, which is not directly related to life extension. The purpose of this study was to analyze the difference in risk acceptance and expectations of LA between four population groups...
September 2014: Archives of Plastic Surgery
Jonathan M Fishman, Katherine Wiles, Mark W Lowdell, Paolo De Coppi, Martin J Elliott, Anthony Atala, Martin A Birchall
INTRODUCTION: Prosthetic materials, autologous tissues, cryopreserved homografts and allogeneic tissues have thus far proven unsuccessful in providing long-term functional solutions to extensive upper airway disease and damage. Research is therefore focusing on the rapidly expanding fields of regenerative medicine and tissue engineering in order to provide stem cell-based constructs for airway reconstruction, substitution and/or regeneration. AREAS COVERED: Advances in stem cell technology, biomaterials and growth factor interactions have been instrumental in guiding optimization of tissue-engineered airways, leading to several first-in-man studies investigating stem cell-based tissue-engineered tracheal transplants in patients...
October 2014: Expert Opinion on Biological Therapy
David G Lott
PURPOSE OF REVIEW: To update readers on the current state and future of head and neck tissue transplantation. RECENT FINDINGS: Many exciting advances have recently occurred in the field of head and neck transplantation and regenerative medicine. Larynx, face, and trachea transplants have all been successfully performed. Significant advancements in tissue engineering have occurred, including the ability to generate three-dimensional tissue structures. Transplantation of regenerated tissues has been successfully incorporated into airway reconstruction...
October 2014: Current Opinion in Otolaryngology & Head and Neck Surgery
Kais Hussein, Berenice Rath, Britta Ludewig, Hans Kreipe, Danny Jonigk
Rare Epstein-Barr virus (EBV)+ smooth muscle tumours (SMT) manifest typically under immunosuppression. Three major subtypes are known: human immunodeficiency virus-associated (HIV-SMT), after transplantation (PTSMT) or associated with congenital immunodeficiency syndromes (CI-SMT). So far, there are no analyses which compare the clinico-pathological characteristics of all three subtypes. Case reports and case series on these three tumour types were collected (1990-2012). Meta-data analysis was performed for identification of similarities and differences...
September 2014: European Journal of Cancer
Jonathan M Fishman, Mark Lowdell, Martin A Birchall
Tissue engineering requires the use of cells seeded onto scaffolds, often in conjunction with bioactive molecules, to regenerate or replace tissues. Significant advances have been made in recent years within the fields of stem cell biology and biomaterials, leading to some exciting developments in airway tissue engineering, including the first use of stem cell-based tissue-engineered tracheal replacements in humans. In addition, recent advances within the fields of scaffold biology and decellularization offer the potential to transplant patients without the use of immunosuppression...
June 2014: Seminars in Pediatric Surgery
Nicolas Guerout, Alexandre Paviot, Nicolas Bon-Mardion, Axel Honoré, Rais Obongo, Célia Duclos, Jean-Paul Marie
Olfactory ensheathing cells (OECs) are neural crest cells which allow growth and regrowth of the primary olfactory neurons. Indeed, the primary olfactory system is characterized by its ability to give rise to new neurons even in adult animals. This particular ability is partly due to the presence of OECs which create a favorable microenvironment for neurogenesis. This property of OECs has been used for cellular transplantation such as in spinal cord injury models. Although the peripheral nervous system has a greater capacity to regenerate after nerve injury than the central nervous system, complete sections induce misrouting during axonal regrowth in particular after facial of laryngeal nerve transection...
2014: Journal of Visualized Experiments: JoVE
Bin Zhang, Zhen-hua Wu, Ji-chun Yu, Peng Lin
OBJECTIVE: Resection of local advanced hypopharyngeal cancer often results in laryngeal preservation impossible. Free flaps were used to reconstruct and to preserve functional larynx. METHODS: Retrospective review of 11 patients who underwent resections of extended squamous cell carcinoma of hypopharynx from September 2005 to September 2011. Of 11 patients, 5 had T3 lesions and 6 had T4 lesions; 2 underwent radiotherapy before surgery and other 9 had postoperative radiotherapy (60 Gy)...
November 2013: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
Robert R Lorenz, Marshall Strome
In 1998, the first successful total laryngeal transplant was performed. Outstanding voice quality and swallowing function were achieved, and over the subsequent 14 years, much was learned about tolerance of a transplanted larynx. After approximately a decade, a slowly progressive, chronic rejection process gradually rendered the organ nonfunctional, and the patient and his providers deemed him appropriate for explantation. This is a report of the clinical indications and outcome surrounding the explantation of the first successful total laryngeal transplant...
April 2014: Otolaryngology—Head and Neck Surgery
S V Starostina, O V Mareev, V N Nikolenko
The objective of the present work was to develop a method for the modification of the vocal cord during the treatment of the patients presenting with unilateral laryngeal paralysis taking into consideration individual peculiarities of stereotopometric characteristics of the larynx in the subjects of different gender, neck structure, and body constitution. The earlier proposed method of laryngostereotopometry was employed in this study. The following body features were measured prior to surgery: the total length, acromial diameter, chest circumference, neck length and circumference; the degree of the fissure of glottis closure was measured by transnasal fibrolaryngoscopy...
2013: Vestnik Otorinolaringologii
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