SCIENTISTS GROW CARTILAGE TO RECONSTRUCT NOSE
Scientists at the
University of Basel report first ever successful nose reconstruction surgery
using cartilage grown in the laboratory. Cartilage cells were extracted from
the patient's nasal septum, multiplied and expanded onto a collagen membrane.
The so-called engineered cartilage was then shaped according to the defect and
implanted. The results will be published in the current edition of the academic
journalThe
Lancet
A research team from
the University of Basel in Switzerland has reported that nasal reconstruction
using engineered cartilage is possible. They used a method called tissue
engineering where cartilage is grown from patients' own cells. This new
technique was applied on five patients, aged 76 to 88 years, with severe
defects on their nose after skin cancer surgery. One year after the
reconstruction, all five patients were satisfied with their ability to breathe
as well as with the cosmetic appearance of their nose. None of them reported
any side effects.
Cells from the nasal
septum
The type of
non-melanoma skin cancer investigated in this study is most common on the nose,
specifically the alar wing of the nose, because of its cumulative exposure to
sunlight. To remove the tumor completely, surgeons often have to cut away parts
of cartilage as well. Usually, grafts for reconstruction are taken from the
nasal septum, the ear or the ribs and used to functionally reconstruct the
nose. However, this procedure is very invasive, painful and can, due to the
additional surgery, lead to complications at the site of the excision.
Together with
colleagues from the University Hospital, the research team from the Department
of Biomedicine at the University of Basel has now developed an alternative
approach using engineered cartilage tissue grown from cells of the patients'
nasal septum. They extracted a small biopsy, isolated the cartilage cells
(chondrocytes) and multiplied them. The expanded cells were seeded onto a collagen
membrane and cultured for two additional weeks, generating cartilage 40 times
the size of the original biopsy. The engineered grafts were then shaped
according to the defect on the nostril and implanted.
New possibilities for
facial reconstruction
According to Ivan
Martin, Professor for Tissue Engineering at the Department of Biomedicine at
the University and University Hospital of Basel, "The engineered cartilage
had clinical results comparable to the current standard surgery. This new
technique could help the body to accept the new tissue better and to improve
the stability and functionality of the nostril. Our success is based on the
long-standing, effective integration in Basel between our experimental group at
the Department of Biomedicine and the surgical disciplines at the University
Hospital. The method opens the way to using engineered cartilage for more
challenging reconstructions in facial surgery such as the complete nose, eyelid
or ear."
The same engineered
grafts are currently being tested in a parallel study for articular cartilage
repair in the knee. Despite the optimistic perspectives, the use of these
procedures in the clinical practice is still rather distant. "We need
rigorous assessment of efficacy on larger cohorts of patients and the development
of business models and manufacturing paradigms that will guarantee
cost-effectiveness," says Martin.
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