Scientists report success growing cartilage to reconstruct nostrils and implanting tissue-engineered vaginal organs into humans

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Two new articles published in The Lancet report the first ever successful operations in humans to reconstruct the alar wings of the nose (nostrils) (Martin et al), and to implant tissue-engineered vaginal organs in women with a rare syndrome that causes the vagina to be underdeveloped or absent (Atala et al), in both cases using the patients’ own tissue.In one paper, led by Professor Ivan Martin from the University of Basel in Switzerland, scientists report having engineered a human cartilage graft from patients’ own nasal septum cartilage cells to successfully rebuild the nostrils (alar lobule) of five individuals whose noses were damaged by skin cancer. One year after reconstruction, all five recipients were satisfied with their ability to breathe, as well as the cosmetic appearance of their nose, and did not report any local or systemic adverse events.The nose is the most common site of non-melanoma skin cancer, because of its cumulative exposure to sunlight, with the highest frequency of cancer occurring on the alar lobule. Currently, when removing skin cancers, surgeons often have to cut away parts of cartilage, (for instance from the nasal septum, ear, or rib) as grafts to functionally reconstruct the tumour excision site. However, this painful and invasive procedure involves major additional surgery, and has been associated with complications at the site from which cartilage has been removed.A team from the University of Basel, Switzerland, investigated an alternative approach using engineered cartilage tissue grown from patients’ own cells. They extracted the cartilage cells (chondrocytes) from the nasal septum of each patient, and multiplied the cells by exposing them to growth factors for two weeks. The expanded cells were seeded onto collagen membranes and cultured for two additional weeks, generating cartilage 40 times larger than the original biopsy. When the engineered grafts were ready they were shaped according to the defect and implanted.According to Professor Martin, “The engineered cartilage had clinical results comparable to the gold standard cartilage graft surgery. This new technique could help the body accept the new tissue more easily, and improve the stability and functionality of the nostril. Our success is based on the long-standing, effective integration in Basel between our experimental group at the Department of Biomedicine and the surgical disciplines. It opens the way to using this engineered cartilage for more challenging reconstructions in facial surgery such as the complete nose, eyelid, or ear. …


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