Biomaterials in the Reconstruction of Nasal Septum Perforation

Abstract

Introduction: Septal perforations are among the most common craniofacial defects. The causes of septal perforations are varied. Objectives: The purpose of the study was to develop a septal cartilage implant biomaterial for use in the reconstruction of nasal septal perforations and prepare personalized implants for each patient individually using 3D printing technology. Methods: Fragments of septal nasal cartilage from 16 patients undergoing surgery for a deviated nasal septum were analyzed to establish microfeatures in individual samples. A scanning electron microscope was used to estimate the microstructure of the removed septal cartilage. 3D models of porous scaffolds were prepared, and a biomaterial was fabricated in the shape of the collected tissue using a 3D printer. Results: Of the various materials used in the Fused Deposition Modeling (FDM) technology of 3D printing, PLLA was indicated as the most useful to achieve the expected implant features. The implant was designed using the indicated pre-designed shape of the scaffold, and appropriate topography, geometry and pore size were included in the design. Conclusions: The implant’s structure allows the use of this device as a framework to carry nanoparticles (antibiotics or bacteriophages). It is possible to create a porous scaffold with an appropriately matched shape and a pre-designed geometry and pore size to close nasal septal perforations even in cases of large septal cartilage defects.

Establishing a point-of-care additive manufacturing workflow for clinical use

“…More widely known is 3-D printing’s application in mandibular and maxilla reconstructive surgeries, wherein new grafts can be similarly pre-bent and sculpted to the original anatomy, or the 3-D patient models can be constructed to mirror the opposing anatomy and ultimately also decrease intraoperative timing [ 99 – 101 ]. Among others, there is further utility in otolaryngology for OSA [ 102 ], auricular scaffolds [ 103 ], nasal septal perforation and scaffolding [ 104 ], and in skull-based surgery [ 71 ]. As a wide-ranging preoperative tool, 3D printing remains well integrated into many fields including plastic surgery, urology, orthopedics, and hepatobiliary surgery among many others helping to depict and better navigate abnormal anatomy for favorable patient outcomes [ 105 – 108 ].…”

Gradientowe Rusztowania Biologiczne O Zmiennej Porowatości

“…inż., prof. ATH, Akademia Techniczno-Humanistyczna w Bielsku-Białej, Wydział Budowy Maszyn i Informatyki, Katedra Podstaw Budowy Maszyn, irajzer@ath.bielsko.pl powinna sprzyjać narastaniu komórek odpowiedniego rodzaju [2,3]. W przypadku defektów kostno-chrzęstnych, strukturę implantu należy dostosować w taki sposób, aby ułatwić namnażanie się komórek kostnych oraz chrzęstnych [4,5]. Komórki te charakteryzują się różną wielkością, dlatego porowatość biologicznego rusztowania również powinna być zmienna [6].…”

Poly(vinyl alcohol)/Gelatin Scaffolds Allow Regeneration of Nasal Tissues

“…From an anatomical point of view, different tissue types are present in the nose including cartilage, bone, fibrous, muscle, adipose, and epithelial, which are structurally interconnected with each other through ligaments of different thickness. The integrity of all the anatomical components is essential for the respiratory function [2][3][4].…”

“…The nasal septum acts as a support for the other nose structures to confer rigidity, thus preventing its permanent deformation. Through the lateral cartilages, the nose interfaces with the nasal bones, such as the vomer, the perpendicular plate of ethmoid bone, and incisive bone, which determine nose anchoring to the facial structures [4,6]. Proceeding from the surface to the depth of the nose, a series of layers are present, made up of different tissues devoted to stability and protection against mechanical shocks along with ensuring the correct organ function: the adipose panniculus, the fibromuscular layer rich in vessels, muscles and ligaments, the deep adipose layer and the muco-perichondrium [7][8][9].…”

“…Given its filtering function and its position, the nose is exposed to a series of injuries of traumatic, chemical, inflammatory and tumorigenic origin [4]. The most common injuries are septal deformations, which cause obstructions of the airways.…”