Etiopathogenetic factors of wound healing in chronic post-intubation cicatricial stenosis of the larynx and trachea

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Despite the existing modern high-tech methods of examination and a variety of surgical treatment methods, the problem of diagnosis, treatment and rehabilitation of patients with chronic post-intubation cicatricial stenosis of the larynx and trachea still requires further study. Improving the understanding and correction of cellular, molecular genetic and biochemical disorders in a chronic wound is a key condition for increasing the efficiency of diagnosis, individual prognosis of the clinical course and the conduct of adequate therapeutic and preventive measures for post-intubation cicatricial laryngotracheal stenoses. In this regard, it seemed appropriate to analyze the existing etiopathogenetic factors of pathological wound healing in chronic post-intubation cicatricial stenosis of the larynx and trachea. Our attempt to summarize the available literature data demonstrated that laryngotracheal scars are a fibro-proliferative disease caused by aberrant wound healing after a damaging effect on the tissues of the larynx and trachea. The article describes the most pathogenetically significant healing, repair, and scarring factors in post-intubation laryngotracheal stenoses, including transforming growth factor β1, vascular growth factor A, type I and III collagen, and matrix metalloproteinases. An assessment of the features of the diagnostic and prognostic significance of these markers will increase the effectiveness of the treatment of patients with chronic cicatricial stenosis of the larynx and trachea, and will also serve as a prerequisite for the development of strategies for diagnostic, treatment, prophylactic and rehabilitation measures that will improve the quality of medical care and the quality of life of patients with chronic cicatricial stenosis of the larynx and trachea.

Keywords:

TGF-β1

VEGF-A

collagen types I and III

MMR-2

MMR-9

chronic post-intubational scar stenosis of the larynx and trachea

Authors:

Vavin V.V.

State autonomous public health institution «Kemerovo Regional Clinical Hospital», Kemerovo, Russia, 650066

Kuznetsova D.A.

Pavlov First Saint Petersburg State Medical University, Saint Petersburg, Russia

Nazhmudinov I.I.

Research and Clinical Department of the Diseases of Upper Respiratory Tracts, Research and Clinical Centre of Otorhinolaryngology, Russian Federal Medico-Biological Agency, Moscow, Russia

Davudov H.Sh.

FSBI Scientific-clinical center of otorhinolaryngology of FMBA of Russia, Moscow, Russia

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