混合三维打印耳组织支架与自体软骨减轻软组织并发症。
Hybrid Three-Dimensional-Printed Ear Tissue Scaffold With Autologous Cartilage Mitigates Soft Tissue Complications.
机构信息
Department of Pediatrics, University of California Los Angeles Mattel Children's Hospital, Los Angeles, California, U.S.A.
Department of Biologic and Materials Sciences, School of Dentistry, University of Michigan, Ann Arbor, Michigan, U.S.A.
出版信息
Laryngoscope. 2021 May;131(5):1008-1015. doi: 10.1002/lary.29114. Epub 2020 Oct 6.
OBJECTIVES/HYPOTHESIS: To analyze the use of highly translatable three-dimensional (3D)-printed auricular scaffolds with and without novel cartilage tissue inserts in a rodent model.
STUDY DESIGN
Preclinical rodent animal model.
METHODS
This prospective study assessed a single-stage 3D-printed auricular bioscaffold with or without porcine cartilage tissue inserts in an athymic rodent model. Digital Imaging and Communications in Medicine computed tomography images of a human auricle were segmented to create an external anatomic envelope filled with orthogonally interconnected spherical pores. Scaffolds with and without tissue inset sites were 3D printed by laser sintering bioresorbable polycaprolactone, then implanted subcutaneously in five rats for each group.
RESULTS
Ten athymic rats were studied to a goal of 24 weeks postoperatively. Precise anatomic similarity and scaffold integrity were maintained in both scaffold conditions throughout experimentation with grossly visible tissue ingrowth and angiogenesis upon explantation. Cartilage-seeded scaffolds had relatively lower rates of nonsurgical site complications compared to unseeded scaffolds with relatively increased surgical site ulceration, though neither met statistical significance. Histology revealed robust soft tissue infiltration and vascularization in both seeded and unseeded scaffolds, and demonstrated impressive maintenance of viable cartilage in cartilage-seeded scaffolds. Radiology confirmed soft tissue infiltration in all scaffolds, and biomechanical modeling suggested amelioration of stress in scaffolds implanted with cartilage.
CONCLUSIONS
A hybrid approach incorporating cartilage insets into 3D-printed bioscaffolds suggests enhanced clinical and histological outcomes. These data demonstrate the potential to integrate point-of-care tissue engineering techniques into 3D printing to generate alternatives to current reconstructive surgery techniques and avoid the demands of traditional tissue engineering.
LEVEL OF EVIDENCE
NA Laryngoscope, 131:1008-1015, 2021.
目的/假设：分析在啮齿动物模型中使用具有和不具有新型软骨组织插入物的高度可翻译的三维（3D）打印耳支架。
研究设计
临床前啮齿动物动物模型。
方法
这项前瞻性研究评估了一种具有或不具有猪软骨组织插入物的单阶段 3D 打印耳生物支架在无胸腺啮齿动物模型中的应用。对人类耳廓的数字成像和通信医学计算机断层扫描图像进行分割，以创建一个充满正交互连的球形孔的外部解剖包络。通过激光烧结生物可吸收聚己内酯打印具有和不具有组织插入部位的支架，然后将每个组中的 5 只大鼠分别植入皮下。
结果
对 10 只无胸腺大鼠进行了研究，以达到术后 24 周的目标。在整个实验过程中，两种支架条件都保持了精确的解剖相似性和支架完整性，在取出时可以看到明显的组织向内生长和血管生成。与未接种支架相比，接种软骨的支架具有相对较低的非手术部位并发症发生率，且具有相对增加的手术部位溃疡，但均无统计学意义。组织学显示接种和未接种支架中均有大量的软组织浸润和血管生成，并证明接种软骨的支架中软骨的活力得到了很好的维持。放射学证实了所有支架中的软组织浸润，生物力学建模表明在植入软骨的支架中减轻了支架的应力。
结论
将软骨插入物纳入 3D 打印生物支架的混合方法表明可以改善临床和组织学结果。这些数据表明，可以将即时组织工程技术整合到 3D 打印中，以产生替代当前重建手术技术的方法，并避免传统组织工程的需求。
证据水平
无喉科学，131：1008-1015，2021。
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