Özkaya Özay, Karşidag Semra, Egemen Onur, Akçal Arzu Özcan, Şirvan Selami, Kabukçuoglu Fevziye
Department of Plastic Reconstructive and Aesthetic Surgery, Okmeydanı Training and Research Hospital, Istanbul, Turkey.
J Craniofac Surg. 2012 Jul;23(4):1028-31. doi: 10.1097/SCS.0b013e31824dfa49.
The tarsal plate is the skeleton support system of the eyelids; therefore, repair during eyelid reconstruction is crucial. Many autogenous graft materials have been proposed for the tarsal reconstruction, such as nasal cartilage, palatal mucosa, upper eyelid tarsus, and auricular cartilage. Nail thickness and shape are similar to the tarsal plate with enough support for the eyelid. It also easily integrates with host tissues. The aim of this experimental study was to macroscopically and histopathologically compare nail xenografts with cartilage autografts when used in eyelid reconstruction in rabbits.
In total, 12 New Zealand rabbits were used in the experiment. Full-thickness defect with a 1-cm diameter was created in both upper eyelids. The right upper eyelids were used for cartilage autograft reconstruction, and the left upper eyelids were used for nail xenograft reconstruction. All animals were killed on week 12 after eyelid reconstruction. After the animals were killed, the upper eyelids of the rabbits were resected for macroscopic and histologic analysis.
In histologic evaluation, moderate foreign body giant cell formation and moderate histiocytic, neutrophilic, basophilic, and lymphocytic infiltration were observed in both experimental group and control group. In addition, this marked fibrous capsule formation was observed around the nail xenograft, which was absent in the cartilage autograft group.
Nail has some advantages such as being cost-effective, being easy to obtain, and having less rejection risk for being composed of dead cells. Nail xenografts can be taken into account instead of cartilage grafts in eyelid reconstruction.
睑板是眼睑的骨骼支撑系统,因此在眼睑重建过程中的修复至关重要。许多自体移植材料已被提出用于睑板重建,如鼻软骨、腭黏膜、上睑睑板和耳软骨。指甲的厚度和形状与睑板相似,对眼睑有足够的支撑作用。它也很容易与宿主组织整合。本实验研究的目的是在兔眼睑重建中,从宏观和组织病理学方面比较指甲异种移植物与软骨自体移植物。
实验共使用12只新西兰兔。在上眼睑制造直径为1厘米的全层缺损。右上眼睑用于软骨自体移植重建,左上眼睑用于指甲异种移植重建。所有动物在眼睑重建后第12周处死。动物处死后,切除兔的上眼睑进行宏观和组织学分析。
在组织学评估中,实验组和对照组均观察到中度异物巨细胞形成以及中度组织细胞、中性粒细胞、嗜碱性粒细胞和淋巴细胞浸润。此外,在指甲异种移植物周围观察到明显的纤维包膜形成,而软骨自体移植组未出现这种情况。
指甲具有一些优点,如成本效益高、易于获取且由于由死细胞组成而排斥风险较小。在眼睑重建中,可以考虑使用指甲异种移植物代替软骨移植物。