Techniques in the Safe Use of Polycaprolactone in Structural Rhinoplasty

Yap, Eduardo C.

doi:10.32412/pjohns.v35i1.1267

Cited by 2 publications

(3 citation statements)

References 13 publications

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“…It is advisable that the surrounding tissues are cartilage so that after 2-3 years when the PCL is totally resorbed it will be replaced with the ingrown cartilage. 8 Polycaprolactone should not be used for pressure or weight bearing purposes because it may extrude or break during the process of healing.…”

Section: What Is Polycaprolactone?mentioning

confidence: 99%

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Understanding the Use of Polycaprolactone in East Asian Structural Rhinoplasty: Questions and Answers

Yap¹

2021

Philipp J Otolaryngol Head Neck Surg

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Surgery as an art in rhinoplasty involves grafting techniques wherein materials (usually autologous) are taken from the septum and supplemented by conchal cartilage. However, not all noses have adequate cartilage material. The quest for materials as possible replacement for human tissue have led to invention of synthetic (e.g. silicone, e-PTFE, porous polyethelene) and non-synthetic products (e.g. processed homograft and xenograft). In this era of advanced medical science, tissue engineering has started the use polycaprolactone (PCL) as a template and scaffold for tissue growth. Because of this characteristic feature, PCL as a mesh has a significant role in structural rhinoplasty. What is structural rhinoplasty? The surgical goal of rhinoplasty is to achieve functional improvement in breathing and aesthetic overall look, most notably the tip. The tip is determined by the final shape of the lower cartilage in its proper location - - but since the lower cartilage is a floating structure supported only by fibrous tissue and ligaments, there is a high incidence of tip drooping post op. So, the idea of structured rhinoplasty was conceptualized in 1997 by Dr. Byrd and popularized by Dr. Toriumi.1,2 A piece of central septum is harvested and fashioned as an extension of the caudal margin of the septum. This is called a septal extension graft (SEG) and the lower cartilage is sutured to the caudal margin of the SEG for better control of the tip. Since then, the technique has been the main workhorse support graft for the tip.3 (Figure 1) Why is structural rhinoplasty needed in East Asian noses? East Asian noses, particularly Southeast Asian noses are usually short and small, with low dorsum and upturned bulbous nose. Tremendous strength in the design of the structural support with its foundation base at the caudal septum should be achieved in order to elongate the nose, counter rotate and project the tip. (Figure 2) This is made possible by using the central harvested cartilage as a SEG attached to the residual strong dorsal and caudal strut.4 (Figure 3)

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Section: What Is Polycaprolactone?mentioning

confidence: 99%

“…It is advised also to avoid direct contact of PCL to mucosa. 8 (Figure 11)…”

Section: Why Is Pcl Used As Esg and Seg In Structural Rhinoplasty?mentioning

confidence: 99%

Understanding the Use of Polycaprolactone in East Asian Structural Rhinoplasty: Questions and Answers

Yap¹

2021

Philipp J Otolaryngol Head Neck Surg

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“… 16 Among many possible materials to be used as a scaffold for nasal cartilage reconstruction, polycaprolactone (PCL) seems suitable as it is an absorbable and porous material which has been used in numerous clinical applications, 17 including rhinoplasty. 18 , 19 Furthermore, PCL-based scaffolds have tunable properties, 20 and their biocompatibility and long-term efficacy and safety in humans are well known. 21 Cell-free materials could theoretically be used to restore damaged cartilage tissue and provide a scaffold for endogenous cell proliferation onto focal defects.…”

Section: Introductionmentioning

confidence: 99%

Ex Vivo Maturation of 3D-Printed, Chondrocyte-Laden, Polycaprolactone-Based Scaffolds Prior to Transplantation Improves Engineered Cartilage Substitute Properties and Integration

et al. 2022

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Objective The surgical management of nasal septal defects due to perforations, malformations, congenital cartilage absence, traumatic defects, or tumors would benefit from availability of optimally matured septal cartilage substitutes. Here, we aimed to improve in vitro maturation of 3-dimensional (3D)-printed, cell-laden polycaprolactone (PCL)-based scaffolds and test their in vivo performance in a rabbit auricular cartilage model. Design Rabbit auricular chondrocytes were isolated, cultured, and seeded on 3D-printed PCL scaffolds. The scaffolds were cultured for 21 days in vitro under standard culture media and normoxia or in prochondrogenic and hypoxia conditions, respectively. Cell-laden scaffolds (as well as acellular controls) were implanted into perichondrium pockets of New Zealand white rabbit ears ( N = 5 per group) and followed up for 12 weeks. At study end point, the tissue-engineered scaffolds were extracted and tested by histological, immunohistochemical, mechanical, and biochemical assays. Results Scaffolds previously matured in vitro under prochondrogenic hypoxic conditions showed superior mechanical properties as well as improved patterns of cartilage matrix deposition, chondrogenic gene expression ( COL1A1, COL2A1, ACAN, SOX9, COL10A1), and proteoglycan production in vivo, compared with scaffolds cultured in standard conditions. Conclusions In vitro maturation of engineered cartilage scaffolds under prochondrogenic conditions that better mimic the in vivo environment may be beneficial to improve functional properties of the engineered grafts. The proposed maturation strategy may also be of use for other tissue-engineered constructs and may ultimately impact survival and integration of the grafts in the damaged tissue microenvironment.

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Techniques in the Safe Use of Polycaprolactone in Structural Rhinoplasty

Cited by 2 publications

References 13 publications

Understanding the Use of Polycaprolactone in East Asian Structural Rhinoplasty: Questions and Answers

Understanding the Use of Polycaprolactone in East Asian Structural Rhinoplasty: Questions and Answers

Ex Vivo Maturation of 3D-Printed, Chondrocyte-Laden, Polycaprolactone-Based Scaffolds Prior to Transplantation Improves Engineered Cartilage Substitute Properties and Integration

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