Verwoerd-Verhoef H L, Bean J K, van Osch G J, ten Koppel P G, Meeuwis J A, Verwoerd C D
Department of Otorhinolaryngology, Erasmus University Medical Center Rotterdam, The Netherlands.
Am J Rhinol. 1998 Jan-Feb;12(1):27-31. doi: 10.2500/105065898782103061.
In the craniofacial region, defects of cartilage structures are preferably reconstructed with autologous cartilage. Donor-site morbidity related to the creation of a new defect elsewhere, and a lack of growth potential of the graft--mandatory in children--have stimulated investigators to find other ways to generate new "extra" cartilage. Several biomaterials have been tested as a matrix for the ingrowth of (peri)chondroblasts in experimental animals. In young (growing) rabbits we have developed a process of heterotopic cartilage induction with the use of a demineralized (bovine) bone matrix which is enfolded in a pedicled flap of ear perichondrium for at least three weeks. During this period the demineralized matrix is colonized by macrophages and polymorphonuclear cells which start a process of complete biodegradation of the material. Simultaneously, the collagen matrix is invaded by mesenchymal cells, originating from the perichondrium and differentiating into chondroblasts and later, into chondrocytes forming the intercellular substance. The developing, very young cartilage could be demonstrated as collagen type II, thus, hyaline cartilage. When applied with its adherent perichondrium as a graft, it merges easily with the more matured host cartilage and even appears to be capable of further growth. Therefore, it seems suitable for the reconstruction of a cartilaginous defect in growing cartilaginous structures like the nasal septum or the larynx.
在颅面区域，软骨结构缺损最好用自体软骨进行重建。与在其他部位制造新缺损相关的供区并发症，以及移植物缺乏生长潜力（这在儿童中是必需的），促使研究人员寻找其他方法来生成新的“额外”软骨。几种生物材料已在实验动物中作为（软骨膜）成软骨细胞向内生长的基质进行了测试。在幼年（生长中的）兔子中，我们开发了一种异位软骨诱导方法，使用脱矿（牛）骨基质，该基质包裹在带蒂的耳软骨膜瓣中至少三周。在此期间，脱矿基质被巨噬细胞和多形核细胞定植，这些细胞开始对材料进行完全生物降解的过程。同时，胶原基质被间充质细胞侵入，这些间充质细胞起源于软骨膜并分化为成软骨细胞，随后分化为形成细胞间质的软骨细胞。发育中的非常年轻的软骨可被证明为II型胶原，即透明软骨。当将其与附着的软骨膜作为移植物应用时，它很容易与更成熟的宿主软骨融合，甚至似乎有能力进一步生长。因此，它似乎适用于重建生长中的软骨结构如鼻中隔或喉部的软骨缺损。
