Drug delivery systems for wound healing treatment of upper airway injury

ABSTRACT

Introduction

Endotracheal intubation is a common procedure to maintain an open airway with risks for traumatic injury. Pathological changes resulting from intubation can cause upper airway complications, including vocal fold scarring, laryngotracheal stenosis, and granulomas and present with symptoms such as dysphonia, dysphagia, and dyspnea. Current intubation-related laryngotracheal injury treatment approaches lack standardized guidelines, relying on individual clinician experience, and surgical and medical interventions have limitations and carry risks.

Areas covered

The clinical and preclinical therapeutics for wound healing in the upper airway are described. This review discusses the current developments on local drug delivery systems in the upper airway utilizing particle-based delivery systems, including nanoparticles and microparticles, and bulk-based delivery systems, encompassing hydrogels and polymer-based approaches.

Expert opinion

Complex laryngotracheal diseases pose challenges for effective treatment, struggling due to the intricate anatomy, limited access, and recurrence. Symptomatic management often requires invasive surgical procedures or medications that are unable to achieve lasting effects. Recent advances in nanotechnology and biocompatible materials provide potential solutions, enabling precise drug delivery, personalization, and extended treatment efficacy. Combining these technologies could lead to groundbreaking treatments for upper airways diseases, significantly improving patients’ quality of life. Research and innovation in this field are crucial for further advancements.

KEYWORDS:

• Drug delivery
• endotracheal intubation
• larynx
• nanotechnology
• biomaterials
• trachea
• vocal folds
• wound healing

Article highlights

• Endotracheal intubation is a commonly performed procedure in several healthcare settings, but intubation trauma and prolonged use often lead to injury.

• The unique and highly functional anatomy of the upper airway poses challenges for drug delivery, where wound healing therapies target the fibrotic and inflammatory processes.

• This review covers the latest developments in laryngotracheal applications of particulate- and bulk-based drug delivery, where their potential, challenges, and utility are discussed.

• Novel strategies may improve treatment through modulable characteristics, enhanced uptake, and long-term therapeutic delivery.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This work was supported by the National Institute of Deafness and Other Communication Disorders under Grant [1R21DC021038-01], the National Institute of Biomedical Imaging and Bioengineering under Grant [1R21EB034840], and CCTST Pilot Collaborative Studies.