A New Avenue for Treating Airway Narrowing in Infants
Children's Hospital of Philadelphia (CHOP) researchers have developed a novel method to enlarge pediatric airways affected by severe subglottic stenosis. This new approach uses a decellularized meniscus scaffold (MEND) that is recellularized with cartilage progenitor cells derived from the ear.
In a preclinical model, the technique outperformed the current standard—costal cartilage grafts—with no adverse events reported.
A key advantage is speed: the scaffold can be prepared in less than a month. This is a significant improvement over the six months typically required for engineered cartilage, offering a faster, more readily available solution for infants in critical need.
The Background on Subglottic Stenosis
Severe subglottic stenosis is a narrowing of the airway just below the vocal cords, affecting an estimated 20,000 infants each year. For severe cases, the standard treatment is laryngotracheal reconstruction (LTR), which requires grafting cartilage from the patient's rib cage.
However, young children often lack sufficient costal cartilage, which can lead to surgical delays or a higher risk of needing follow-up surgery. This new method aims to bypass those limitations entirely.
The Science Behind the Scaffold
Published in Nature Communications on June 17, 2026, the study was led by Riccardo Gottardi, PhD, and Ian Jacobs, MD. The team created the scaffold by removing cells, elastin, and blood vessels from meniscal cartilage. This "skeleton" is then repopulated with cartilage progenitor cells.
The goal was to create a biocompatible graft that integrates seamlessly with surrounding tissue.
Key Quotes from the Researchers:
"We needed something that could be equivalent to a piece of cartilage, integrate well, be well tolerated, and regrow." – Riccardo Gottardi, PhD
"This research shows promising data that this approach could overcome autograft-associated limitations in laryngotracheal reconstruction." – Ian Jacobs, MD
Funding and Support
The study was made possible by grants from:
- 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