Lab-grown cartilage to fix cancer patients’ noses

Cancer patients can look forward to new techniques in facial reconstruction after researchers from the University of Basel in Switzerland successfully reconstructed the noses of five skin cancer patients using cartilage grown from their own tissue.

As reported in The Lancet medical journal, scientists used a technique called tissue engineering to extract very small amounts of cartilage from the patients’ noses and then amplified the tissue in the lab. The result was a relatively large mass of white, glossy cartilage, which could be shaped easily to suit each patient’s nose. Five patients aged 76 to 88 and with severe defects on their nose after skin cancer surgery underwent the new technique. A year later, all five said they were satisfied with their ability to breathe as well as the aesthetic appearance of their nose. None of them reported any side effects.

New method for nasal reconstruction

According to Ivan Martin, Professor for Tissue Engineering at the Department of Biomedicine at the University and University Hospital of Basel, “The engineered cartilage had clinical results comparable to current standard surgery.” Surgeons currently have to treat this condition by completely removing tumours on the nose. Often they have to cut away vital areas of cartilage during the process. This new nasal reconstruction method could be very appealing for those suffering from non-melanoma skin cancer, which commonly occurs on the nose following cumulative exposure to sunlight.

With the new method, the researchers isolate cartilage cells and multiply them using a combination of growth factors. “First of all, we use an extract from the patient’s own blood, and add an autologous serum as a concentrate to spur growth. So we use some synthetic protein to boost the velocity of the growth, while maintaining the cartilage’s capacity to regenerate in the future,” Martin explains.

After around two weeks, the amplified cells are seeded onto a collagen membrane scaffold and cultured for two further weeks. After the four weeks, the pieces of cartilage expand to 40 times the size of the original biopsy. This gives the surgeons a large amount of tissue to work with as they shape it to fit the individual patient’s features. 

“The outcome of the procedure was to determine its safety and feasibility, which is measured in terms of adverse events and stability. In all five cases, there were no adverse events, and the patients could breathe as well in both nostrils, indicating complete satisfaction,” said Martin. 

Implications for future research

Tissue engineering opens the way to the use of engineered cartilage for more challenging reconstructions in facial surgery, such as complete noses, eyelids and ears. Similar grafts are currently being tested in a parallel study for articular cartilage repair in the knee. However, we are still a long way off from seeing such procedures used in clinical practice. Many cheaper smart materials and artificial implants are currently being used to heal and regenerate tissues.

Further links:
Unibas.ch
Sciencedaily.com