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Several therapeutic effects of photobiomodultion (PBM) on variable mucosal lesions of the upper aerodigestive tract has been reported. However, the biomodulatory effect of PBM are rarely reported on tracheostomy and tracheal fenestration, which has been increased with the spread of coronavirus disease (COVID-19). In this study, we developed a translaryngeal PBM therapy by using a basket-integrated diffusing applicator (BIDA) to ameliorate the wound healing of fenestrated tracheostoma after surgery. Tracheostomy was performed by using an electrocautery unit (Bovie) to develop an in vivo porcine model of fenestrated tracheostoma with impaired wounds. A 635 nm laser light (200 mW/cm2 for 3 min, 36 J/cm2) was applied to the wounds by using BIDA once daily for five days. BIDA was inserted in tracheostomy tube and emitted homogeneous circumferential light into the fenestrated wound without thermal damage. Control highly induced fibrotic expressions of alpha-smooth muscle actin and type-1 collagen with acute inflammation. In contrast, PBM reduced the expressions up to less than 82% of control. Histological scores presented that PBM significantly decreased acute inflammation and overgranulation to two-thirds of control with a small portion of abscess. In addition, a substantial difference in the lumen area was observed between the control and PBM due to the thickened wall. The current study demonstrated that the proposed PBM therapy could ameliorate the impaired wound healing of fenestrated tracheostoma as a result of modulated inflammation and fibrotic responses. Therefore, the translaryngeal PBM with BIDA can be an effective adjuvant therapy for managing the fenestrated wound after tracheostomy.
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