Abstract：
BACKGROUND: A lack of ideal filling materials is a critical limitation in current rhinoplasty. Cartilage sheet regeneration by autologous chondrocytes is expected to provide an ideal source of material. However, the inability to perform minimally invasive transplantation of cartilage sheets has greatly limited the clinical application of this material. In this article, the authors propose the concept of injectable cartilage microtissue (ICM) based on cartilage sheet technology, with the aim of achieving minimally invasive augmentation rhinoplasty in clinical practice.
METHODS: Approximately 1.0 cm2 of posterior auricular cartilage was collected from 28 patients. Isolated chondrocytes were expanded, then used to construct autologous cartilage sheets by high-density seeding and in vitro culture in chondrogenic medium with cytokines (eg, transforming growth factor beta-1 and insulin-like growth factor-1) for 3 weeks. Next, ICM was prepared by granulation of the cartilage sheets; it was then injected into a subcutaneous pocket for rhinoplasty.
RESULTS: ICM was successfully prepared in all patients, and its implantation efficiently raised the nasal dorsum. Magnetic resonance imaging confirmed that regenerative tissue was present at the injection site; histologic examinations demonstrated mature cartilage formation with typical cartilage lacunae and abundant cartilage-specific deposition of extracellular matrix. Excellent or good postoperative patient satisfaction results were achieved in 83.3% of patients over 5 years of follow-up. Obvious absorption of grafts occurred in only two patients (8.3%).
CONCLUSIONS: These results demonstrated that ICM could facilitate stable cartilage regeneration and long-term maintenance in the human body; the implantation of ICM enabled natural augmentation of the depressed nasal dorsum.
METHODS: Therapeutic, IV.
METHODS: Approximately 1.0 cm2 of posterior auricular cartilage was collected from 28 patients. Isolated chondrocytes were expanded, then used to construct autologous cartilage sheets by high-density seeding and in vitro culture in chondrogenic medium with cytokines (eg, transforming growth factor beta-1 and insulin-like growth factor-1) for 3 weeks. Next, ICM was prepared by granulation of the cartilage sheets; it was then injected into a subcutaneous pocket for rhinoplasty.
RESULTS: ICM was successfully prepared in all patients, and its implantation efficiently raised the nasal dorsum. Magnetic resonance imaging confirmed that regenerative tissue was present at the injection site; histologic examinations demonstrated mature cartilage formation with typical cartilage lacunae and abundant cartilage-specific deposition of extracellular matrix. Excellent or good postoperative patient satisfaction results were achieved in 83.3% of patients over 5 years of follow-up. Obvious absorption of grafts occurred in only two patients (8.3%).
CONCLUSIONS: These results demonstrated that ICM could facilitate stable cartilage regeneration and long-term maintenance in the human body; the implantation of ICM enabled natural augmentation of the depressed nasal dorsum.
METHODS: Therapeutic, IV.
摘要：
背景：缺乏理想的填充材料是当前隆鼻的关键限制。通过自体软骨细胞再生软骨片有望提供理想的材料来源。然而,无法进行软骨片的微创移植极大地限制了这种材料的临床应用。在这篇文章中,作者提出了基于软骨片技术的可注射软骨微组织（ICM）的概念，目的是在临床实践中实现微创隆鼻。
方法：从28名患者中收集约1.0cm2的耳后软骨。扩增分离的软骨细胞，然后通过高密度接种和在具有细胞因子的软骨形成培养基中的体外培养来构建自体软骨片（例如，转化生长因子β-1和胰岛素样生长因子-1）3周。接下来,ICM通过软骨片的颗粒化制备;然后将其注射到皮下口袋中用于隆鼻。
结果：所有患者都成功准备了ICM，它的植入有效地提高了鼻背。磁共振成像证实注射部位存在再生组织；组织学检查显示成熟的软骨形成，具有典型的软骨空洞和丰富的软骨特异性细胞外基质沉积。在5年的随访中，83.3％的患者获得了优异或良好的术后患者满意度结果。只有两名患者（8.3％）明显吸收移植物。
结论：这些结果表明，ICM可以促进人体内稳定的软骨再生和长期维持；ICM的植入使鼻背凹陷自然增强。
方法：治疗，IV.
方法：从28名患者中收集约1.0cm2的耳后软骨。扩增分离的软骨细胞，然后通过高密度接种和在具有细胞因子的软骨形成培养基中的体外培养来构建自体软骨片（例如，转化生长因子β-1和胰岛素样生长因子-1）3周。接下来,ICM通过软骨片的颗粒化制备;然后将其注射到皮下口袋中用于隆鼻。
结果：所有患者都成功准备了ICM，它的植入有效地提高了鼻背。磁共振成像证实注射部位存在再生组织；组织学检查显示成熟的软骨形成，具有典型的软骨空洞和丰富的软骨特异性细胞外基质沉积。在5年的随访中，83.3％的患者获得了优异或良好的术后患者满意度结果。只有两名患者（8.3％）明显吸收移植物。
结论：这些结果表明，ICM可以促进人体内稳定的软骨再生和长期维持；ICM的植入使鼻背凹陷自然增强。
方法：治疗，IV.
