Optimizing a patient-specific regenerative larynx implant for restoration of voice

优化患者特异性再生喉植入物以恢复声音

• 批准号: 10472454
• 负责人: David G Lott
• 金额: $ 63.79万
• 依托单位: MAYO CLINIC ARIZONA
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10472454
• 关键词: Anatomy; Atrophic; Back; Biomedical Engineering; Breathing; Canis familiaris; Child; Cicatrix; Clinical; Complex; Coughing; Deglutition; Development; Enteral Feeding; Epithelial; Family; Feasibility Studies; Flaccid Muscle Tone; Foundations; Generations; Goals; Harvest; Human; Immune response; Immunology; Implant; Laryngeal Mucosa; Larynx; Left; Life; Minor; Modeling; Morbidity - disease rate; Mucous body substance; Muscle; Operative Surgical Procedures; Patients; Performance; Physics; Positioning Attribute; Process; Prosthesis; Quality of life; Reconstructive Surgical Procedures; Robot; Savings; Shapes; Site; Social isolation; Speech-Language Pathology; Stomach; Structure; Surgical Flaps; Surgical Management; Testing; Tissues; Tracheostomy Tube; Tube; Voice; Work; design; experience; functional outcomes; functional restoration; healing; homograft; implant design; improved; improved outcome; in vivo; in vivo Model; multidisciplinary; novel; prototype; reconstruction; regenerative; restoration; scaffold; stem cell biology; wound; wound healing

Abstract The larynx governs our most basic life-sustaining functions and serves as the foundation of our self-identity. Even the most minor aberration within this delicate and complex structure can result in life-altering or life- ending consequences. The ability to breathe, swallow, and voice are all regulated by the larynx. Even though these functions can be replaced with various tubes and prosthetics, they cannot replace the normal human experience. Patients state that losing their voice feels like losing their identity. They wish to talk with their own voice again, sing to their children, and have a meal with their families. Coughing mucus out of a tracheostomy tube, feeding one’s self through a stomach tube, and speaking like a robot are embarrassing, leading most to live a life of social isolation. Development of a bioengineered patient-specific implant can restore all three laryngeal functions and improve healing, thereby saving lives and improving quality-of-life. The goal of our project is to optimize a process and a product to restore all three laryngeal functions -- breathing, swallowing, and voice -- with a patient-specific, immobile hemilarynx implant that obviates the need for revision surgery, improves healing, and enhances implant integration. To achieve our goal we will complete the following 3 aims: Aim 1: To refine the design process for a patient-specific implant shape, we will quantify voicing, breathing, and swallowing of excised larynges tested with different patient-specific implants. Aim 2: To optimize laryngeal wound healing without the muscle flap, we will evaluate flat scaffold patches with cellular and acellular components in an in vivo model of a laryngeal mucosal wound. Aim 3: To evaluate the performance of the bioengineered implant in a long-term in vivo hemilarynx reconstruction model, we will assess immune response, tissue integration, epithelial development, and function -- voicing, breathing, and swallowing -- with canine-specific implants with both optimal shape and optimal cellular and acellular components.

摘要