Proliferation rate of human osteoblast-like cells on alloplastic biomaterials and their clinical application for the transnasal duraplasty procedure

Abstract

The possibility of transmission of slow virus infection (HIV) and Creutzfeld-Jakob disease by cadaveric dura implants makes it necessary to find synthetic, absorbable materials for the reconstruction of the dura mater. Various procedures with autologous or alloplastic material are described. Four commerically available biomaterials were choosen to study the proliferation rate and the biocompatibility of human osteoblast-like cells (HOB-like cells) on 2-dimensional material by biochemical analysis. With a proliferation assay, the viability and the proliferation capacity of osteoblast-like cells were evaluated. A clinical trial was added to study resorbable fleece as one of the previously tested biomaterial in a small patient group (8 patients) to close anterior cranial fossa dura defects. The results of the proliferation assay showed the highest proliferation rate of HOB-like cells on resorbable fleece. All patients in our clinical trial with anterior cranial fossa dura defects were successfully treated with resorbable fleece. There was no evidence for persisting cerebrospinal fluid rhinorrhea or foreign body reaction after the period of wound healing. The present study demonstrated an excellent biocompatibility of resorbable fleece. The vicryl fleece is an alternative alloplastic material for endonasal closure of defined substantial defects of the dura with cerebrospinal fluid.

Biomaterials in skull base surgery

“…Ellis reports that PDS ® -Foils are not approved in the USA for orbita floor reconstruction [ 32 ]. Observations of greater activation of osteoblast-like cells by Ethisorb ® than by PDS ® in the culture model [ 18 ], [ 19 ] agree with the good results reported by Büchel after implantation of an Ethisorb-Foil ® under the aspect of osteoneogenesis on the orbita floor.…”

“…However, there is evidence that when biomaterial is introduced, the bony frontobasis can also be stimulated to osteoneogenesis. In culture models, Arndt [ 18 ] and Itthichaisri [ 19 ] investigated the proliferation rates of osteoblast-like cells (HOB-like cells) after application to various biomaterials. The greatest activity was observed in the cell proliferation test in contact with Ethisorb ® ; by contrast, the proliferation rate in contact with PDS ® was ten times lower.…”