Middle ear mucosal regeneration by tissue-engineered cell sheet transplantation.
Middle ear mucosal regeneration by tissue-engineered cell sheet transplantation.
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DOI：
10.1038/s41536-017-0010-7
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发表时间：
2017
影响因子：
7.2
通讯作者：
Kojima H
中科院分区：
文献类型：
--
作者：
Yamamoto K;Yamato M;Morino T;Sugiyama H;Takagi R;Yaguchi Y;Okano T;Kojima H
手术治疗后胆脂瘤的复发，往往是由于中耳腔及乳突腔粘膜再生不良及肉芽组织形成等改变，影响中耳腔内气体交换所致。传统的鼓室成形术常常导致乳突腔切除区域粘膜再生不足。特别是，在充气不良的乳突腔中，粘膜再生是非常困难的。如果中耳手术后能保留中耳黏膜或实现外露骨面黏膜的术后快速再生，则有可能改善包括胆脂瘤在内的中耳炎的手术治疗效果，恢复中耳的生理功能。为了克服这些局限性，我们开发了一种鼓室成形术和自体鼻黏膜上皮细胞片移植相结合的中耳黏膜术后再生治疗方法。在临床研究中，我们通过内窥镜切除了一块约10 × 10 mm2的鼻黏膜组织。组织工程的自体鼻黏膜上皮细胞片是通过在无菌环境中，在符合良好生产规范的细胞处理设备中培养收获的细胞来制备的。在鼓室成形术中，将培养的细胞片移植到鼓室和乳突腔中粘膜丢失的暴露的骨表面上。我们对4例中耳胆脂瘤患者和1例粘连性中耳炎患者进行了该手术。所有患者均表现出良好的术后病程，无不良事件和并发症，患者移植后听力保持良好。从鼻部移植一层细胞到中耳可以改善中耳炎症的术后预后。日本纪庆大学医学院的Kazuhisa Yamamoto及其同事开发了一种新的手术技术，以防止慢性中耳疾病的术后复发。在粘连性中耳炎中，鼓膜被吸入并卡在中耳腔中。胆脂瘤涉及中耳皮肤的异常生长。由于中耳粘膜上皮的再生延迟，手术治疗后往往复发。这项新技术包括在手术期间将培养细胞从鼻腔内壁移植到中耳。5例患者术后无不良反应或并发症，听力水平有满意的改善。
The recurrence of cholesteatoma after surgical treatment often occurs as a result of poor mucosal regeneration in the middle ear cavity and mastoid cavity and changes, such as granulation tissue formation, which impair gas exchange in the middle ear cavity. Conventional tympanoplasty often results in a lack of mucosal regeneration in the resected area of the mastoid cavity. In particular, mucosal regeneration in a poorly pneumatized mastoid cavity is extremely difficult. If the middle ear mucosa can be preserved or rapid postoperative regeneration of mucosa on the exposed bone surface can be achieved after middle ear surgery, the results of surgical treatment for otitis media, including cholesteatoma, can potentially be improved and the physiological function of the middle ear can be recovered. To overcome these limitations, we developed a novel treatment method combining tympanoplasty and autologous nasal mucosal epithelial cell sheet transplantation for postoperative regeneration of the middle ear mucosa. In clinical research, we endoscopically removed an approximately 10 × 10 mm2 piece of nasal mucosal tissue. Tissue-engineered autologous nasal mucosal epithelial cell sheets were fabricated by culturing the harvested cells in an aseptic environment in a good manufacturing practice-compliant cell processing facility. The cultivated cell sheets were transplanted, during tympanoplasty, onto the exposed bony surface of the attic of the tympanic and mastoid cavities where the mucosa had been lost. We performed this procedure on four patients with middle ear cholesteatoma and one patient with adhesive otitis media. All patients showed favorable postoperative course with no adverse events or complications and the patients’ hearing ability post-transplantation remained good. Transplanting a sheet of cells from the nose to the middle ear could improve postoperative prognosis for middle ear inflammatory conditions. Kazuhisa Yamamoto of Jikei University School of Medicine and colleagues in Japan developed a novel surgical technique to prevent postoperative recurrence of chronic middle ear conditions. In adhesive otitis media, the eardrum gets sucked into and stuck in the middle ear space. Cholesteatoma involves abnormal skin growth in the middle ear. Recurrence often follows surgical treatment for these conditions due to delays in regeneration of the middle ear’s mucosal epithelium. The new technique involves transplanting cultured cells from the lining of the nasal cavity to the middle ear during surgery. Five patients treated this way had favorable postoperative outcomes with no adverse effects or complications and satisfactory improvement in hearing levels.
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DOI：
10.1002/jbm.820271005
发表时间：
1993-10-01
期刊：
JOURNAL OF BIOMEDICAL MATERIALS RESEARCH
影响因子：
--
作者：
OKANO, T;YAMADA, N;SAKURAI, Y
通讯作者：
SAKURAI, Y
影响因子：
2.5
作者：
VARTIAINEN, E
通讯作者：
VARTIAINEN, E
影响因子：
2.6
作者：
Takahashi, H;Honjo, I;Toda, H
通讯作者：
Toda, H
影响因子：
2.6
作者：
Tanabe, M;Takahashi, H;Sudo, M
通讯作者：
Sudo, M
影响因子：
158.5
作者：
Nishida, K;Yamato, M;Tano, Y
通讯作者：
Tano, Y