Three-dimensional printing of a patient-specific engineered nasal cartilage for augmentative rhinoplasty

Abstract

Autologous cartilages or synthetic nasal implants have been utilized in augmentative rhinoplasty to reconstruct the nasal shape for therapeutic and cosmetic purposes. Autologous cartilage is considered to be an ideal graft, but has drawbacks, such as limited cartilage source, requirements of additional surgery for obtaining autologous cartilage, and donor site morbidity. In contrast, synthetic nasal implants are abundantly available but have low biocompatibility than the autologous cartilages. Moreover, the currently used nasal cartilage grafts involve additional reshaping processes, by meticulous manual carving during surgery to fit the diverse nose shape of each patient. The final shapes of the manually tailored implants are highly dependent on the surgeons’ proficiency and often result in patient dissatisfaction and even undesired separation of the implant. This study describes a new process of rhinoplasty, which integrates three-dimensional printing and tissue engineering approaches. We established a serial procedure based on computer-aided design to generate a three-dimensional model of customized nasal implant, and the model was fabricated through three-dimensional printing. An engineered nasal cartilage implant was generated by injecting cartilage-derived hydrogel containing human adipose-derived stem cells into the implant containing the octahedral interior architecture. We observed remarkable expression levels of chondrogenic markers from the human adipose-derived stem cells grown in the engineered nasal cartilage with the cartilage-derived hydrogel. In addition, the engineered nasal cartilage, which was implanted into mouse subcutaneous region, exhibited maintenance of the exquisite shape and structure, and striking formation of the cartilaginous tissues for 12 weeks. We expect that the developed process, which combines computer-aided design, three-dimensional printing, and tissue-derived hydrogel, would be beneficial in generating implants of other types of tissue.

In vitro study on chondrogenic differentiation of human adipose-derived stem cells on treated bovine pericardium

“…We first confirmed tBP as a cell-friendly scaffold regarding the in vitro cytotoxicity on hADSCs (Figures 4-6), and its ability to support hADSC attachment and proliferation ( Figure 7). These results about the in vitro biocompatibility of tBP demonstrate its capability to repair and regenerate tissues (Yi et al, 2019), therefore contributing to the integration and maintenance of the grafted tBP in augmentation rhinoplasty. In order to strengthen the application potential of tBP in augmentation rhinoplasty, tBP was evaluated for supporting the chondrogenic differentiation of hADSCs.…”

Combining Innovative Bioink and Low Cell Density for the Production of 3D-Bioprinted Cartilage Substitutes: A Pilot Study

“…MSC three-dimensional (3D) bioprinting is an emerging technology that is expected to revolutionize the field of regenerative medicine [6,20,[38][39][40], including hyaline articular cartilage engineering [41][42][43][44][45][46][47][48][49][50][51][52]. Previous tissue engineering approaches for cartilage repair usually failed to generate functional tissues recapitulating the zonal organization, extracellular matrix (ECM) content, and biomechanical properties of native cartilage.…”

Three‐dimensional printing: The potential technology widely used in medical fields

“…And 3D printing technology can provide a reasonable structure for adipose stem cells in tissue engineering. So it can be used for rebuilding the nasal type (Yi et al, 2019), auricle regeneration (Lee et al, 2014; Visscher et al, 2016), rebuilding the maxillofacial cartilage (Morrison et al, 2018), filling defect of bone (Roskies et al, 2017; Wang et al, 2016; Wenz, Borchers, Tovar, & Kluger, 2017), reconstruction of blood vessels (Zhao et al, 2016), and even printing organs (Kapur et al, 2012). Noor et al (2019) reprogrammed the omental tissue cells into pluripotent stem cells and then differentiated them into cardiomyocytes and endothelial cells.…”