"The goal was to create a material equivalent to a piece of cartilage that would integrate well and be tolerated."
— Riccardo Gottardi, PhD
New Tissue Engineering Method Offers Hope for Children with Severe Airway Narrowing
Researchers at Children's Hospital of Philadelphia (CHOP) and the University of Pennsylvania have announced a significant advancement in the treatment of severe subglottic stenosis in children. The findings, published in Nature Communications on June 17, 2026, detail a novel tissue engineering approach designed to overcome the limitations of current surgical techniques.
The Challenge: A Critical Shortage of Cartilage
Severe subglottic stenosis is a dangerous narrowing of the airway just below the vocal cords, affecting an estimated 20,000 infants each year.
Currently, the standard treatment is a complex surgery called laryngotracheal reconstruction (LTR). This procedure requires surgeons to harvest cartilage grafts from the patient’s own rib cage.
Reported limitations of this approach include:
- Potential complications at the graft donor site.
- Insufficient cartilage volume in very young children.
- Necessary delays in surgery while awaiting growth.
The Innovation: The MEND Scaffold
The new method introduces a specialized biomaterial called the MEND scaffold (a decellularized meniscus scaffold).
How it is made:
- The Scaffold: Meniscal cartilage is processed to remove all cells, elastin, and blood vessels, leaving behind a natural matrix.
- The Cells: This scaffold is then repopulated with cartilage progenitor cells harvested from the patient's own ear.
Key efficiency:
The scaffold can be prepared in less than a month, a timeframe significantly shorter than the six months typically required for producing conventional engineered cartilage.
Key Findings: Superior Performance in Preclinical Testing
In a preclinical model, the MEND scaffold demonstrated better performance compared to the current standard of costal cartilage grafts. Additionally, no adverse events were reported during the study.
Expert Perspectives
Ian Jacobs, MD, stated that the data suggests this approach could successfully overcome the key limitations associated with autografts in laryngotracheal reconstruction.
Funding & Support
The study was made possible by grants from the following institutions:
- National Heart, Lung, and Blood Institute
- CHOP Research Institute
- Frontier Program in Airway Disorders
- National Science Foundation
- University of Pennsylvania
- American Society of Pediatric Otolaryngology
- National Institute of Arthritis and Musculoskeletal and Skin Diseases