Svistushkin V M, Timashev P S, Lobacheva V V, Zolotova A V, Svistushkin M V, Kosheleva N V, Shevchik E A, Nikiforova G N, Shpichka A I, Nikiforova A N, Tychkina I A
Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
Vestn Otorinolaringol. 2024;89(2):21-27. doi: 10.17116/otorino20248902121.
Nasal septal perforation (NSP) is a complex problem in otorhinolaryngology, which leads to impaired nasal breathing and dryness in the nose. This reduces the patient's quality of life and leads to psychological discomfort. The treatment of nasal septum perforation is selected taking into account the clinical manifestations, perforation parameters and general condition of the patient. Currently, a large number of different surgical methods have been described in order to closing the defect of nasal septum. To date, there is no universally accepted method for closing NSP, which stimulates the search and development of new treatment options.
Under experimental conditions, to study a new method for closing nasal septum perforation using a collagen scaffold together with adipose stromal vascular fraction containing multipotent mesenchymal stromal cells.
The experiment was carried out on a model of nasal septum perforation in 24 male rabbits divided into four groups, depending on the construct, implanted into the defect zone: the 1st group was the control group - without the introduction of implantation material; the 2nd group - collagen scaffold without adipose stromal vascular fraction; the 3rd group - collagen scaffold with xenogenic adipose stromal vascular fraction; the 4th group - collagen scaffold with allogeneic adipose stromal vascular fraction with further dynamic evaluation of endoscopic control on day 14, after 1 month, 3 months, and 6 months. At month 6, the animals were removed from the experiment, followed by morphological examination in color with hematoxylin and eosin, as well as safranin and methyl green.
As a result of the experiment using adipose stromal vascular fraction of allogeneic and xenogenic origin, closing of perforation of the nasal septum of a rabbit for 3 months of dynamic endoscopic control, as well as according to morphological research, was demonstrated.
Our study showed that the use of adipose stromal vascular fraction containing not only endothelial cells and pericytes, but also multipotent mesenchymal stromal cells in combination with a collagen scaffold closes the perforation of the nasal septum in a rabbit, without increasing the risk of violations of habitual vital activity.
鼻中隔穿孔（NSP）是耳鼻咽喉科的一个复杂问题，会导致鼻呼吸受损和鼻腔干燥。这会降低患者的生活质量并导致心理不适。鼻中隔穿孔的治疗会根据临床表现、穿孔参数和患者的一般状况来选择。目前，为了闭合鼻中隔缺损，已经描述了大量不同的手术方法。迄今为止，尚无一种被普遍接受的闭合鼻中隔穿孔的方法，这促使人们去寻找和开发新的治疗方案。
在实验条件下，研究一种使用胶原蛋白支架结合含有多能间充质基质细胞的脂肪间充质血管成分来闭合鼻中隔穿孔的新方法。
在24只雄性兔子的鼻中隔穿孔模型上进行实验，根据植入缺损区域的构建物将其分为四组：第一组为对照组，不引入植入材料；第二组为不含脂肪间充质血管成分的胶原蛋白支架；第三组为含异种脂肪间充质血管成分的胶原蛋白支架；第四组为含同种异体脂肪间充质血管成分的胶原蛋白支架，并在第14天、1个月、3个月和6个月后进行内镜控制的动态评估。在第6个月时，将动物处死，随后进行苏木精和伊红染色以及番红和甲基绿染色的形态学检查。
实验结果表明，使用同种异体和异种来源的脂肪间充质血管成分，在3个月的动态内镜控制以及形态学研究中，兔子的鼻中隔穿孔均实现了闭合。
我们的研究表明，使用不仅含有内皮细胞和周细胞，还含有多能间充质基质细胞的脂肪间充质血管成分与胶原蛋白支架相结合，可闭合兔子的鼻中隔穿孔，且不会增加破坏正常生命活动的风险。
