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同种异体保存软骨的肉成形术。动物实验中的组织形态学模型(作者译)

[Meatoplasty with allogenic preserved cartilage. Histomorphological model in animal experiments (author's transl)].

作者信息

Waller G, Pesch H J, Weidenbecher M, Nique M

出版信息

Arch Otorhinolaryngol. 1976 Nov 15;214(2):132-42.

PMID:63280
Abstract

The reconstruction of the posterior wall of the external acoustic meatus destroyed by surgery or a cholesteatoma is necessary for the complete restoration of function. For this purpose, allogen cartilage preserved in thiomersalate has been transplanted on the anterior wall of the air-containing mastoid bone in 160 clinical cases. The histomorphological reaction of the recipient to unilaterally uncovered transplant material has previously been unknown. In 10 guinea pigs, 15 fenestrated bullae (hypotympanum equivalents) were closed with cartilage transplants fixed in place with tissue adhesive. After a period varying between 7 1/2 and 11 months, the walls of the bullae with the transplant were then examined histomorphologically. Despite the variations in the period in situ, the avital cartilage transplant, which remained largely constant in volume and shape, was always to be found. It was tolerated without reaction and was "enveloped"--also on the primarily uncovered surface--by a capsule of bone and connective tissue. In no case was rejection observed. Marked foreign-body reaction was, however, found in the vicinity of the tissue adhesive, which was absorbed only slowly. The clinically well-known tissue-compatible and complication free behaviour of the allogenic cartilage transplant preserved in thiomersalate, is thus explained by the histomorphological findings. In contrast, the fact that marked foreign-body reaction was demonstrable even after almost one year, suggests that tissue adhesive should not be used.

摘要

对于因手术或胆脂瘤而受损的外耳道后壁进行重建,是功能完全恢复所必需的。为此,已将保存在硫柳汞中的同种异体软骨移植到160例含气乳突骨前壁。此前,受体对单侧未覆盖移植材料的组织形态学反应尚不清楚。在10只豚鼠身上,用组织粘合剂固定的软骨移植片封闭了15个开窗的大疱(相当于下鼓室)。在7个半月至11个月不等的一段时间后,对带有移植片的大疱壁进行组织形态学检查。尽管原位时间不同,但始终能发现无活力的软骨移植片,其体积和形状基本保持不变。它能被耐受而无反应,并被骨和结缔组织包膜“包裹”——在最初未覆盖的表面也是如此。未观察到排斥反应。然而,在组织粘合剂附近发现了明显的异物反应,组织粘合剂吸收缓慢。硫柳汞保存的同种异体软骨移植在临床上众所周知的组织相容性和无并发症行为,因此可以通过组织形态学发现来解释。相比之下,即使在将近一年后仍能证明有明显的异物反应,这表明不应使用组织粘合剂。

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