Kim Do Hyun, Lee Il Hwan, Yun Won-Soo, Shim Jin-Hyung, Choi Dami, Hwang Se Hwan, Kim Sung Won
Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Banpo-daero 222, Seocho-gu, Seoul, 137-701, Republic of Korea.
Department of Otolaryngology-Head and Neck Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Republic of Korea.
Eur Arch Otorhinolaryngol. 2022 Apr;279(4):1943-1950. doi: 10.1007/s00405-021-06996-y. Epub 2021 Jul 21.
To investigate the long-term safety and efficacy of a 3D-printed bioresorbable polycaprolactone (PCL) nasal implant for nasal septal deformity reconstruction.
Fourteen patients who had undergone nasal septum reconstruction surgery using 3D-printed PCL nasal septal implants were enrolled. The primary outcome was the change in total Nasal Obstruction Symptom Evaluation (NOSE) scale scores between postoperative 3 months and current status (3.59 ± 0.51 years). The secondary outcomes were changes in the minimum cross-sectional area (MCA) and volume of both nasal cavities based on acoustic rhinometry, the cross-sectional area of the ostiomeatal unit, and the nasal septum angle of the paranasal sinus (PNS) in computed tomography (CT) images, and a visual analog scale (VAS) of the patients' subjective satisfaction.
The results showed no significant changes in the MCAs (Cohen's d:0.09; p = 0.711) or nasal volume (Cohen's d:0.26; p = 0.356), the area of the ostiomeatal unit (Cohen's d:0.49; p = 0.064), septum angles (Cohen's d:0.18; p = 0.831), the NOSE scale (Cohen's d:0.14; p = 0.621), or patients' subjective satisfaction (Cohen's d:0.52; p = 0.076) during the follow-up period.
This homogeneous composite microporous PCL nasal septal implant demonstrated long-term clinical efficacy and safety in human tissues that required maintenance of mechanical strength. Therefore, the indications for this implant could extend to various other craniofacial reconstructions in the future.
探讨用于鼻中隔畸形重建的3D打印生物可吸收聚己内酯(PCL)鼻植入物的长期安全性和有效性。
招募了14例使用3D打印PCL鼻中隔植入物进行鼻中隔重建手术的患者。主要结局指标是术后3个月至当前状态(3.59±0.51年)期间鼻阻塞症状评估(NOSE)量表总分的变化。次要结局指标包括基于鼻声反射测定法的两个鼻腔最小横截面积(MCA)和容积的变化、鼻窦计算机断层扫描(CT)图像中窦口鼻道复合体的横截面积、鼻中隔角度,以及患者主观满意度的视觉模拟量表(VAS)。
结果显示,随访期间MCA(科恩d值:0.09;p = 0.711)、鼻腔容积(科恩d值:0.26;p = 0.356)、窦口鼻道复合体面积(科恩d值:0.49;p = 0.064)、鼻中隔角度(科恩d值:0.18;p = 0.831)、NOSE量表(科恩d值:0.14;p = 0.621)或患者主观满意度(科恩d值:0.52;p = 0.076)均无显著变化。
这种均质复合微孔PCL鼻中隔植入物在需要维持机械强度的人体组织中显示出长期临床疗效和安全性。因此,该植入物的适应证未来可能会扩展到其他各种颅面重建。