A Swiss research team has successfully performed nose reconstruction surgery with cartilage grown from the patient’s own tissue, advancing reconstructive surgery as well as personalized medicine.
Dr. Ivan Martin, a researcher at the University Hospital of Basel and senior author of the study, said that the new method could eliminate the discomfort and risks attending current surgical techniques. "The engineered cartilage had clinical results comparable to the current standard surgery,” he explained in a press release. “This new technique could help the body to accept the new tissue better and to improve the stability and functionality of the nostril.”
Nasal reconstruction typically relies on grafts taken from the septum, ears, and ribs. However, this method is painful, and can lead to other complications later on. The new technique, called tissue engineering, lets surgeons grow the grafts in the lab, removing the need for multiple surgery sites.
To investigate, Martin and colleagues recruited five patients with severe nose defects from skin cancer surgery. After extracting small biopsies from each patient’s nose, the team isolated the cartilage cells, allowing them to grow and multiply over a several weeks. At the end of the cultivation period, the samples had grown to 40 times their original size. These lab-grown grafts were then shaped according to the patient’s defect and implanted
The results, published in the journal The Lancet, show that the engineered graft represents a viable alternative to current surgical methods, with all subjects reporting great satisfaction with nose function and appearance following the procedure. “Our success is based on the long-standing, effective integration in Basel between our experimental group at the Department of Biomedicine and the surgical disciplines at the University Hospital,” Martin explained.
The study is the latest in a line of breakthroughs in regenerative medicine. Another example is a paper from earlier this month, in which researchers from the University of Edinburgh successfully rebuilt the thymus of very old lab mice. And last summer, a Japanese research team announced that they’d grown a functional rudimentary liver from stem cells.
Despite the promising results, it may take some time before the new technique becomes a staple of reconstructive care. “We need rigorous assessment of efficacy on larger cohorts of patients and the development of business models and manufacturing paradigms that will guarantee cost-effectiveness,” Martin told reporters.
Source: Fulco I, Miot S, Huag MD, Martin I, et al. Engineering autologous cartilage tissue for nasal reconstruction after tumour resection: an observational first-in-human trial. The Lancet. 2014.