Department of Otorhinolaryngology - Head and Neck Surgery, College of Medicine, Ewha Womans University, Seoul, Korea.
Department of Molecular Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea.
Am J Rhinol Allergy. 2021 Jul;35(4):417-425. doi: 10.1177/1945892420961971. Epub 2020 Sep 30.
Nasal septal perforation is caused by bilateral septal mucosal injuries resulting from nasal trauma and septal surgeries. Previous studies have reported that biocompatible materials may be effective for repairing nasal septal perforations. However, they were primarily used for treatment; no study has investigated their use for prevention of nasal septal perforation.
To determine whether porcine tracheal mucosa-derived decellularized patch can prevent the progression of nasal mucosa injuries to septal perforations.
Bilateral nasal septal mucosal defects were surgically induced in 36 rabbits. Silastic sheets were applied bilaterally in all rabbits, and decellularized mucosal patch was applied unilaterally (n = 12) or bilaterally (n = 12) at the defect site in the respective experimental groups. Between 1 and 8 weeks postoperatively, the animals were sacrificed, and their nasal septa were completely removed. The excised septa were examined macroscopically and microscopically (histopathological examinations). Moreover, glycosaminoglycan (GAG) estimations of the septa were performed to evaluate mucosal regeneration and mechanical properties.
Septal perforations occurred in 5 animals in the control group (5/12; 42%), 1 in the unilateral group (1/12; 9%), and in none in the bilateral group. Compared with the control group, the experimental groups showed significantly different mucosal and cartilage regeneration.
Decellularized porcine tracheal mucosa can prevent mucosal defects from progressing to septal perforation, promote the repair of mucosal defects, and protect the nasal cartilage.
鼻中隔穿孔是由于双侧鼻中隔黏膜损伤引起的，其原因包括鼻外伤和鼻中隔手术。既往研究报道，生物相容性材料可能对修复鼻中隔穿孔有效，但这些材料主要用于治疗，尚无研究探讨其在预防鼻中隔穿孔方面的应用。
评估猪气管黏膜去细胞贴片能否预防鼻中隔黏膜损伤进展为鼻中隔穿孔。
采用手术方法在 36 只兔双侧鼻中隔黏膜造成缺损。所有兔双侧均应用硅橡胶片，实验组于缺损处单侧（n = 12）或双侧（n = 12）应用去细胞黏膜贴片。术后 1~8 周处死动物，完整取出鼻中隔。大体和组织学检查（组织病理学检查）观察切除的鼻中隔。此外，对鼻中隔进行糖胺聚糖（glycosaminoglycan，GAG）测定，评估黏膜再生和力学特性。
对照组 5 只兔（5/12；42%）发生鼻中隔穿孔，单侧组 1 只兔（1/12；9%）发生穿孔，双侧组未发生穿孔。与对照组相比，实验组的黏膜和软骨再生明显不同。
去细胞猪气管黏膜可预防鼻中隔黏膜缺损进展为穿孔，促进黏膜缺损修复，保护鼻软骨。
