Department of ORL-HNS, the Affiliated East Hospital of Tongji University, and School of Medicine, Tongji University, Shanghai, China; The Royal College of Surgeons of England, London, United Kingdom.
School of Materials Science and Engineering, Tongji University, Shanghai, China.
Acta Biomater. 2020 May;108:46-55. doi: 10.1016/j.actbio.2020.04.012. Epub 2020 Apr 11.
The surgical implant is an interdisciplinary therapeutic modality that offers unique advantages in the daily practice of otorhinolaryngology. Some well-known examples include cochlear implants, bone-anchored hearing aids, sinus stents, and tracheostomy tubes. Neuroprotective, osteogenic, anti-inflammatory, and antimicrobial effects are among their established or pursued functions. Implant-based drug delivery affords an efficient and potent approach to enhancing these therapeutic functions. Recent innovations have infiltrated all four elements of a drug-eluting implant. The purpose of this pre-clinical, biotechnology-oriented review is to discuss these developments in terms of the implant biomaterial, loaded medication, delivery pattern, and system fabrication. Cell-mediated neurotrophin release, fabrication of a hydroxyapatite-supported system, biodegradable polymer-based implants, and multiclass and multidrug delivery are some representative advancements. The ultimate goal here is to bridge the gap between biotechnology advances and clinical needs. The review is concluded with a perspective regarding the future opportunities and challenges in this popular and rapidly developing subject of research. STATEMENT OF SIGNIFICANCE: Surgical implants and local drug delivery are representative modern modalities of surgical treatment and medical treatment, respectively. Their synergy offers unique therapeutic advantages, such as minimal systemic side effects, proximity-related high efficiency, and potential absorbability. The applications of implant-based drug delivery have infiltrated otorhinolaryngology and head & neck surgery, which is well known for its related tissue diversity and surgical complexity. Examples discussed here include cochlear implants, bone-anchored hearing aids, sinus stents, and airway tubes. This timely review focuses primarily on the four fundamental components of an implant-based drug delivery system, namely implant biomaterial, loaded medication, delivery pattern, and system fabrication. A particular emphasis is placed upon the in vitro cellular and in vivo animal studies that demonstrate pre-clinical potentials.
外科植入物是一种跨学科的治疗方式，在耳鼻喉科的日常实践中具有独特的优势。一些著名的例子包括人工耳蜗植入物、骨锚式助听器、窦支架和气管造口管。其已确立或正在研究的功能包括神经保护、成骨、抗炎和抗菌作用。基于植入物的药物输送提供了一种增强这些治疗功能的高效和有力的方法。最近的创新已经渗透到药物洗脱植入物的四个要素中。本临床前、以生物技术为导向的综述的目的是根据植入物生物材料、负载药物、输送模式和系统制造来讨论这些进展。细胞介导的神经营养因子释放、制造支持羟基磷灰石的系统、可生物降解聚合物基植入物以及多类和多药物输送是一些有代表性的进展。这里的最终目标是弥合生物技术进步与临床需求之间的差距。该综述以对这一热门且快速发展的研究主题的未来机遇和挑战的看法结束。
外科植入物和局部药物输送分别是外科治疗和药物治疗的代表性现代方式。它们的协同作用提供了独特的治疗优势，例如最小的全身副作用、与位置相关的高效率和潜在的可吸收性。基于植入物的药物输送的应用已经渗透到耳鼻喉科和头颈外科，该领域以其相关组织多样性和手术复杂性而闻名。这里讨论的例子包括人工耳蜗植入物、骨锚式助听器、窦支架和气道管。本次及时的综述主要侧重于基于植入物的药物输送系统的四个基本组成部分，即植入物生物材料、负载药物、输送模式和系统制造。特别强调了展示临床前潜力的体外细胞和体内动物研究。
