A Novel Endotracheal Tube-Based Electrode for Noninvasive Treatment of Tracheal Stenosis

Abstract

Abstract. Tracheal stenosis is a condition characterized by narrowing of the trachea due to congenital anomalies or prolonged intubation. It is conventionally treated with surgical procedures such as tracheal resection and reconstruction. These are associated with recurrence of stenosis, inflammation, and sepsis. There is a growing interest in developing minimally invasive techniques for reshaping tracheal cartilage. Electromechanical reshaping (EMR) has emerged as a promising approach, but the use of conventional flat and double-sided strip electrodes limits its safety and clinical applicability. The trachea presents a challenging scenario wherein noninvasive access is limited to the luminal side. We have designed a novel single-sided strip electrode configuration which can be applied on the luminal side of the trachea. Using ex vivo goat tracheal cartilages, we optimized the dosimetry for efficient shape retention. Live-dead imaging to analyze the cell death, dimethyl methylene blue (DMMB) assay to assess the release of sulfated glycosaminoglycans (sGAG), attenuated total reflection Fourier transform infrared (ATR-FTIR) spectroscopy to assess the molecular changes in the reshaped trachea and histopathology to assess the tissue integrity after reshaping confirmed minimal tissue damage and effective shape retention with the single-sided strip electrode. The single-sided strip electrode was tested on a whole ex vivo goat trachea, and the results demonstrated a significant increase in tracheal airway diameter, highlighting its effectiveness and practical applicability. These findings suggest that the single-sided strip electrode configuration provides a minimally invasive and effective method for reshaping tracheal cartilage, presenting a promising alternative for treating tracheal stenosis.