Laryngotracheal Stenosis: Drug Delivery Approaches and Strategies
Abstract
Laryngotracheal stenosis (LTS) refers to narrowing of the airway at the vocal folds, subglottis, or cervical trachea and is observed in adults usually following prolonged intubation, tracheostomy, or trauma. Current understanding of pathophysiology suggests that an autofeedback loop stemming from the immune response, activates inflammatory pathways, leading to fibroblast proliferation, and excessive extracellular matrix production resulting in fibroplasia and airway stenosis. Airway stenosis and disrupted mucociliary clearance lead to deterioration of upper airway function necessitating medical and, most often, surgical intervention. Oral, intravenous, or locally injected therapeutics can reduce inflammation and fibrosis, yet most cases necessitate endoscopic or open surgical interventions to provide a safe airway. Due to poor anatomical accessibility and lack of novel and tolerable treatment options for patients, targeted local drug administration is necessary to maximize therapeutic efficacy and minimize systemic side-effects remains limited. In this manuscript, currently available therapeutic choices across various interventional drug delivery and administration approaches/models used in vitro, in vivo, and in clinical cases of LTS treatment are reviewed.
Document Details
- Document Type
- Technical Report
- Publication Date
- Jul 31, 2022
- Accession Number
- AD1174251
Entities
People
- Gregory R Dion
- Joo L. Ong
- Rena Bizios
- Solaleh Miar
- Teja Guda
Organizations
- 59th Medical Wing