University of Alberta team looks to engineer cartilage to improve nasal surgeries
Cancer patients requiring a new nose would face less pain, fewer complications
Medical researchers at the University of Alberta are pioneering a new process for growing highquality human cartilage in the lab that could soon improve how surgeons perform nasal reconstructions.
Cancer patients requiring a new nose would be subjected to less pain and fewer complications, along with more consistent esthetic results, say the project’s authors, whose work is published in Nature’s Scientific Reports.
“The idea is … what if we could give you pre-fabricated cartilage grafts before you went into the operating room that were specifically designed for that patient’s defect?” team member Dr. Khalid Ansari, a facial plastic and reconstructive surgeon, said Tuesday.
“That’s a paradigm shift in reconstruction.”
Ansari and co-author Dr. Martin Osswald work with skin cancer patients, more than a third of whom develop cancer on their nose that often has to be removed.
This leaves patients with a debilitating disfigurement that can be repaired with a second surgery, though the procedure carries complications and doesn’t always lead to satisfactory results.
Surgeons must remove cartilage from another place on the patient’s body — often the rib or the ear — and then reshape it to mimic the cartilage that was earlier removed from the nose.
The harvested cartilage can often be too hard or brittle, making it challenging to reconstruct the nose exactly as it was.
“Trying to re-create what nature intended becomes difficult,” Ansari said.
To improve the process, the team members decided to turn to the world of tissue engineering.
The approach they tested began by taking cartilage cells from donors and transferring them to an incubator to multiply. Once a sufficient supply was produced, the cells were placed on a specially designed scaffold made of collagen.
“The scaffold can be shaped just like the nose, just like the structure you want to reconstruct,” said Adetola Adesida, a scientist in the U of A’s department of surgery.
“Once you put cells on it, they attach to it and they start making the tissue.”
Should the work eventually progress to a clinical setting, the team envisions it could produce big changes for patient care.
In this vision, patients needing reconstructive surgery would receive a three-dimensional scan to determine the size of the graft they need, followed by a small biopsy of their nose cartilage.
That biopsy would then be used to grow a precise graft over the next several weeks prior to the surgery.
The work builds on previous research conducted by a group in Switzerland. Adesida said the cartilage produced there tended to be of low quality and was highly variable, so his goal with the U of A team was to develop a process to ensure top-quality material for all patients.
The team hopes to have clinical trials underway within two or three years, and also sees a potential opportunity to commercialize the technology.
What if we could give you pre-fabricated cartilage grafts specifically designed for the defect before surgery?