Vertu-Ciolino Delphine, Brunard Fanny, Courtial Edwin-Joffrey, Pasdeloup Marielle, Marquette Christophe André, Perrier-Groult Emeline, Mallein-Gerin Frédéric, Malcor Jean-Daniel
Hospices Civils de Lyon, Hôpital Edouard Herriot, Lyon, France.
Laboratory of Tissue Biology and Therapeutic Engineering, CNRS UMR 5305, University Claude Bernard-Lyon 1 and University of Lyon, Lyon, France.
Tissue Eng Part B Rev. 2024 Dec;30(6):581-595. doi: 10.1089/ten.TEB.2023.0326. Epub 2024 Apr 17.
The repair of nasal septal cartilage is a key challenge in cosmetic and functional surgery of the nose, as it determines its shape and its respiratory function. Supporting the dorsum of the nose is essential for both the prevention of nasal obstruction and the restoration of the nose structure. Most surgical procedures to repair or modify the nasal septum focus on restoring the external aspect of the nose by placing a graft under the skin, without considering respiratory concerns. Tissue engineering offers a more satisfactory approach, in which both the structural and biological roles of the nose are restored. To achieve this goal, nasal cartilage engineering research has led to the development of scaffolds capable of accommodating cartilaginous extracellular matrix-producing cells, possessing mechanical properties close to those of the nasal septum, and retaining their structure after implantation . The combination of a non-resorbable core structure with suitable mechanical properties and a biocompatible hydrogel loaded with autologous chondrocytes or mesenchymal stem cells is a promising strategy. However, the stability and immunotolerance of these implants are crucial parameters to be monitored over the long term after implantation, to definitively assess the success of nasal cartilage tissue engineering. Here, we review the tissue engineering methods to repair nasal cartilage, focusing on the type and mechanical characteristics of the biomaterials; cell and implantation strategy; and the outcome with regard to cartilage repair. Impact statement Nasal septal cartilage is key to the cosmetic and function of the nose. To repair important damage to the nasal septum, current surgical techniques are complex and limited by graft source availability. Conversely, tissue engineering is a promising strategy to reproduce the dimensions and mechanical properties of the nose without causing donor site morbidity. This approach, however, remains overlooked for the reconstruction of the nasal septum compared with other cartilaginous tissues. This review describes the specific challenges associated with nasal cartilage repair and the pioneering studies leading to advances in the growing field of nose tissue engineering.
鼻中隔软骨的修复是鼻部整形和功能性手术中的一项关键挑战，因为它决定了鼻子的形状及其呼吸功能。支撑鼻背对于预防鼻塞和恢复鼻子结构都至关重要。大多数修复或矫正鼻中隔的外科手术都侧重于通过在皮肤下放置移植物来恢复鼻子的外观，而没有考虑呼吸方面的问题。组织工程提供了一种更令人满意的方法，其中鼻子的结构和生物学功能都能得到恢复。为实现这一目标，鼻软骨工程研究已促使开发出能够容纳产生软骨细胞外基质的细胞的支架，这些支架具有接近鼻中隔的机械性能，并在植入后保持其结构。将具有合适机械性能的不可吸收核心结构与负载自体软骨细胞或间充质干细胞的生物相容性水凝胶相结合是一种很有前景的策略。然而，这些植入物的稳定性和免疫耐受性是植入后长期需要监测的关键参数，以最终评估鼻软骨组织工程的成功与否。在此，我们综述修复鼻软骨的组织工程方法，重点关注生物材料的类型和机械特性、细胞及植入策略，以及软骨修复的结果。影响声明鼻中隔软骨对于鼻子的美观和功能至关重要。为修复鼻中隔的严重损伤，当前的手术技术复杂且受移植物来源可用性的限制。相反，组织工程是一种有前景的策略，可在不引起供体部位并发症的情况下重现鼻子的尺寸和机械性能。然而，与其他软骨组织相比，这种方法在鼻中隔重建方面仍被忽视。本综述描述了与鼻软骨修复相关的具体挑战以及在不断发展的鼻组织工程领域取得进展的开创性研究。
