Transplantation of autologous chondrocytes seeded on a fibrin/hyaluronic acid composite gel into vocal fold in rabbits: Preliminary results

Injection laryngoplasty is an option for treatment of glottic insufficiency following vocal fold paralysis, vocal fold atrophy or scarring. We intended to evaluate the plausibility of autologous chondrocytes cultured with fibrin/hyaluronic acid (HA) for permanent vocal fold augmentation. Chondrocytes from rabbit auricular cartilage were expanded and cultured with fibrin/HA composite gel. 0.1 mL dosages of fibrin/HA gel with autologous chondrocytes were injected into the left vocal folds of six rabbits. Four months postoperatively, the site was evaluated endoscopically, histologically, and radiologically. None of the six rabbits showed signs of respiratory distress. Computed tomography images and endoscopic evaluation revealed sufficient augmentation volume of the injected vocal fold. Histologic data showed that the injected material did not migrate from their original insertion site. Even though the number of chondrocyte that settled down and survived in the injected site was varying in rabbits, chondrocytes successfully formed neo-cartilage at four months postoperatively in all cases. Histologically, the grafts showed no signs of inflammatory reaction and were covered with ciliated epithelium. The chondrocytes cultured with fibrin/ HA could be a plausible injection material for vocal fold augmentation.