Transoral grafting for vocal fold scarring using epithelial sheet of oral mucosa

2018 Fiscal Year Final Research Report

• Project/Area Number: 16K20286
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Otorhinolaryngology
• Research Institution: Kurume University
• Principal Investigator: Fukahori Mioko 久留米大学, 医学部, 助教 (50529310)
• Project Period (FY): 2016-04-01 – 2019-03-31
• Keywords: 声帯瘢痕 / 声帯粘膜再生 / 口腔粘膜上皮培養 / 傷害声帯治療 / 経口的移植

Outline of Final Research Achievements

Scarred vocal folds result in irregular vibrations during phonation due to stiffness of the vocal fold mucosa. To date, a completely satisfactory corrective procedure has yet to be achieved. The purpose of this study is to regenerate vocal fold mucosa with the epithelial sheet consisted of autologous oral mucosal cells by the technique of transoral transplantation. Laryngeal endoscope was inserted orally under general anesthesia with endotracheal intubation, the unilateral membranous portion of the vocal fold was resected according to the cordectomy type II method. The resected area was immediately covered with the fabricated epithelial sheet using forceps and fibrin glue. Laryngeal stroboscopy revealed regular but slightly small mucosal waves at the transplanted site. The regenerated vocal fold mucosa on the transplanted portion was morphologically similar to that of the normal side.

Free Research Field

喉頭科学

Academic Significance and Societal Importance of the Research Achievements

ヒト声帯は、組織学的に粘膜上皮、粘膜固有層、筋層の3層構造から成り、その層構造と物性は良好な音声にとって重要である。声帯瘢痕や声帯溝症は、声帯層構造の変化による不可逆的な音声障害を来しうる病態であり確立された治療方法はない。本研究では、これらの難治性疾患に対する治療を目的に、口腔粘膜上皮シートを用いて経口的移植手技による声帯層構造の再生を目指した。口腔粘膜小片より上皮細胞を分離培養し、上皮細胞シートを作成した。瘢痕声帯モデルの瘢痕除去後に直達喉頭鏡下に上皮シートを移植した。移植声帯は正常声帯に近い声帯形であり、粘膜波動が観察された。発声に有利な声帯の物性が再生したことを示唆する結果であった。