Department of Maxillofacial Surgery, Technical University of Munich, Munich, Germany.
Department of Otorhinolaryngology, University Medical Center Ulm, Ulm, Germany.
J Craniomaxillofac Surg. 2019 Apr;47(4):682-694. doi: 10.1016/j.jcms.2019.01.010. Epub 2019 Jan 25.
Autologous cartilage as donor tissue for various surgical reconstructions such as nasal septum regeneration is limited and associated with donor site morbidity. Our goal was to evaluate a new resorbable chondroconductive biomaterial made of decellularized porcine nasal septum cartilage compared with autologous native auricular cartilage as the gold standard. In order to examine the material and determine its long-term outcome further, we used subcutaneous implantation and septal implantation in an orthotopic rabbit model. In addition to non-seeded decellularized xenogenic cartilage, chondrocyte-seeded decellularized xenogenic cartilage was implanted as a septal replacement. After a three- or six-month period, the formation of newly synthesized cartilage extracellular matrix was evaluated immunohistochemically, whereas septal integrity and biocompatibility were evaluated histologically. The formation of the implanted neoseptum and form stability was analyzed by using 7-Tesla Magnetic Resonance Imaging. Good biocompatibility with no excessive rejection was demonstrated in all groups. Long-term stable and reliable septal reconstruction could be achieved in the study groups with or without cell seeding with autologous auricular chondrocytes. Autologous cell seeding was advantageous only with regard to septal perforations. Thus, cell seeding provides a benefit regarding long-term stability. However, because of slightly better biocompatibility, less pronounced septum deviation and the markedly lower effort involved, the non-seeded scaffold is favoured for possible clinical application.
自体软骨作为供体组织，可用于各种外科重建，如鼻中隔再生，但来源有限，且与供体部位的发病率有关。我们的目标是评估一种新的可吸收的软骨传导生物材料，由脱细胞化的猪鼻中隔软骨制成，与自体耳软骨作为金标准进行比较。为了进一步检查材料并确定其长期结果，我们在兔鼻中隔原位模型中进行了皮下植入和鼻中隔植入。除了未种植的脱细胞化异种软骨外，还植入了软骨细胞种植的脱细胞化异种软骨作为鼻中隔替代物。在 3 或 6 个月后，通过免疫组织化学评估新合成的软骨细胞外基质的形成，而通过组织学评估鼻中隔的完整性和生物相容性。使用 7-Tesla 磁共振成像分析植入新鼻中隔的形成和形态稳定性。所有组均表现出良好的生物相容性，无过度排斥反应。在有或没有自体耳软骨细胞种植的情况下，研究组均能实现长期稳定可靠的鼻中隔重建。自体细胞种植仅在鼻中隔穿孔方面具有优势。因此，细胞种植在长期稳定性方面具有优势。然而，由于脱细胞支架具有更好的生物相容性、更轻微的鼻中隔偏曲和明显较低的操作难度，因此更有利于可能的临床应用。
