Engineered Cartilage Used in First Nasal Reconstruction Surgeries

By on April 17, 2014

Researchers at the University of Basel in Switzerland have reported successful nasal reconstruction surgery of cancer patients with lab-grown cartilage. The patients’ own cells were used to create the cartilage with a technique called tissue engineering.

This is the first step in what could be a massive overhaul in surgeries that had previously used smart materials. According to Ivan Martin, Professor for Tissue Engineering at the Department of Biomedicine at the University and University Hospital of Basel, “The engineered cartilage had clinical results comparable to the current standard surgery.”

The type of cancer investigated in this study is known as a non-melanoma skin cancer that is very common in the alar wing of the nose due to the great degree of sunlight it is exposed to. Repairing this kind of defect usually involves the surgeon removing the tumor completely by cutting away parts of healthy cartilage as well.

Martin reports on the more difficulties with the second part of this surgery. “Now, a patient has to take [grafts from] his or her own cartilage tissue – taken from the ears, lips or from the nasal septum. But this requires an additional surgical site, so there’s a risks of infection.” Martin says, “And from an aesthetic standpoint, you have apiece missing from your ear or lips.”

Their tissue-engineered cartilage seeks to eliminate many of these issues but comes with a lengthy preparation. Martin and his team created the lab-grown cartilage by taking small biopsies from the blood of the nasal septum of five patients between 76 and 88 years of age.

All of the patients suffered from severe nasal defects resulting from skin cancer surgery. The researches isolated the cartilage cells (chondrocytes) and multiplied them using a combination of growth factors.

According to Martin, autologous serum was needed as a concentrate that could spur cell growth.

“We added some synthetic protein that further boost the growth velocity and also maintain the cartilage’s capacity of regeneration in the future,” Martin said.

The cartilage was then seeded onto a collagen membrane scaffold after two weeks of amplification and cultured for an additional two weeks. At the end of the four-week period the cartilage piece had grown to 40 times the size of the original sample.

The cartilage was then shaped to fit the needs of each specific patient. The patients appeared to be very pleased with the results and one year after the reconstruction, all five patients were able to breath normally out of both nostrils and were satisfied with the cosmetic changes as well.

Martin believes that tissue engineering can used to tackle even larger biological challenges in the future even outside the realm of skin cancer.

“We are testing the same procedure in cartilage of the knee…We’re running a clinical study where the same patches of engineered cartilage are applied onto the particular surface of injury, and the results are already very promising.” Martin says.

Clinical applications of tissue engineering are still a good ways off until the procedure can become more cost effective. Smart materials and artificial implants are able to produce almost identical results with lower cost. Martin feels that it is possible that smart polymers could be used to active cells at a site to regenerate themselves, but that this mechanism would have to be tissue specific and that tissue engineering would create a more holistic solution.

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