Comparison of the chondrogenic potential of free and vascularized perichondrium in the airway

Revascularized perichondrium or periosteum may be the ideal graft to repair severe laryngotracheal stenosis because of its pliability, potential for bone or cartilage formation, resistance to infection, and rapid mucosalization. To begin our evaluation of these grafts in airway reconstruction, this study was designed to quantify the chondrogenic capacity of free and vascularized perichondrium placed in the airway. In a rabbit model, free auricular perichondrium (N = 16) produced a mean cartilage thickness of 0.15 mm, whereas vascularized auricular perichondrium (N = 18) produced a mean of 0.45 mm at 8 weeks (p < .0001). In a third group of rabbits (N = 4) vascularized auricular perichondrial grafts were subjected to a 2-hour intraoperative ischemic insult in order to simulate the ischemia of revascularization. The mean cartilage thickness at 8 weeks was 0.50 mm. We conclude that in the rabbit model, vascularized perichondrium provides significantly more cartilage than free perichondrial grafts.