Experimental Reconstruction of the Airway with Buccal Mucosa and Cortical Bone in a Single-stage Procedure

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Abstract
Autogenous buccal mucosa and cortical bone were transplanted in a one-stage procedure to an anterior tracheal defect in 5 beagles. The result was studied by endoscopy, light microscopy, scanning electron microscopy and transmission electron microscopy. The bone graft was shaped as an oval disc and perforated with large holes for vascular nutrition of the mucosal graft. Small holes were made along the periphery for suturing the buccal mucosa to the bone disc and for suturing the composite graft to the tracheal defect. The mucosa sloughed off from the framework during the first 2 weeks and the bone graft was subsequently expelled through the airway. The mucosal graft was replaced by ciliated columnar epithelium supported by firm connective tissue. Various surface structures were found in the regenerating epithelium. Although the animals did not suffocate or develop a stenosis, this procedure cannot in its present form be recommended for use in clinical practice.