Placental-Derived Connective Tissue Matrix: Cytokine Array Analysis and Pilot Study of Vocal Fold Injection During Microphonosurgery.

INTRODUCTION: Placental-derived connective tissue matrix (pd-CTM) is rich in extracellular proteins and bioactive factors that may modulate inflammation, fibrosis, and angiogenesis. To our knowledge, its molecular profile has not been characterized in the context of laryngology. The primary aim of this study was to quantify key wound-healing mediators in pd-CTM using proteomic methods. A secondary aim was to describe preliminary clinical observations following pd-CTM injection during microphonosurgical excision of benign true vocal fold lesions. METHODS: Estimated absolute concentrations (ng/mL) of proteins in pd-CTM [CTM Flow™, CTM Biomedical®, Lake Worth, Florida] were measured using a multiplex cytokine array and enzyme-linked immunosorbent assay. For translational context, early postoperative outcomes were reviewed in three patients who received adjuvant pd-CTM injection following microphonosurgical excision. RESULTS: Moderate to high concentrations of anti-inflammatory (IL-1ra), anti-fibrotic (TIMP-2, HGF, bFGF, and TGF-β3) and angiogenic (VEGF, EGF, and PDGF-BB) factors were detected, whereas low concentrations of IL-6, IL-10, GM-CSF, and TGF-β1 were detected in pd-CTM. In the pilot clinical cohort, early (<2 week) postoperative videostroboscopy showed nearly symmetric, periodic waveforms without adverse events. CONCLUSIONS: This study provides a novel cytokine and protein profile of pd-CTM, demonstrating a composition supportive of anti-inflammatory, anti-fibrotic, and pro-angiogenic activity. These findings establish a mechanistic basis for further preclinical investigation and larger-scale clinical trials evaluating pd-CTM as an adjunctive therapy in laryngeal surgery.