Morphological and Histological Findings after Typical Surgical Manipulations on Growing Septal Cartilage in Rabbits

ABSTRACT

One remaining problem of nose surgery is surgical correction of a prepubertal distortion of the septum. Unfortunately, the growing cartilage reacts differently upon a surgical intervention; in most cases this might cause iatrogenic disturbance of the development. Our clinical and histological studies with polydioxanone (PDS) foil in septal reconstruction showed that the PDS foil successfully prevented postoperative sequelae like dislocation of the reimplanted cartilage fragments and recurrent deviation caused by overlapping of the cartilage borders. Furthermore, it seemed to stimulate cartilage regeneration. The question occurs whether the same effect can be expected if growing septal cartilage is supported by the PDS foil. This animal study showed remarkable effects of the resorbable PDS foil in healing and regeneration of the growing septum up to complete resorption of the PDS, which coincidentally paralleled the outgrowth of the septal cartilage in rabbits, such as in cartilage regeneration and in prevention of secondary septal deviations due to bending of the newly formed cartilage or incomplete healing of cut edges.

KEYWORDS

Nasal surgery in children - PDS foil - histological study - cartilaginous healing

REFERENCES

• 1 Krmpotic-Nemanic J. Hals-Nasen-Ohren- Heilkunde in Praxis und Klinik, Entwicklungsgeschichte und Anatomie der Nase und der Nasennebenhöhlen 1-36. Thieme Verlag Stuttgart 1977
• 2 Poublon R ML. The cartilaginous nasal dorsum and the postnatal growth of the nose [Ph.D. dissertation]. Eburon Publisher, Delft, The Netherlands 1987
• 3 Lang J. Über das postnatale Wachstum der Außennase.  Gegenb Morph Jahrb. 1987;  133 5-32
• 4 Van Loosen J. A cephalometric analysis of nasal septal growth.  Clin Otolaryngol. 1997;  22 453-458
• 5 Nolst Trenité G J, Verwoerd C DA, Verwoerd-Verhoef H L. Reimplantation of autologous septal cartilage in the growing nasal septum.  Rhinology. 1988;  26 25-32
• 6 Verwoerd C DA, Verwoerd-Verhoef H J, Meeuwis C A et al.. Wound healing of autologous implants in the nasal septal cartilage.  ORL J Otorhinolaryngol Relat Spec. 1991;  53 310-314
• 7 Bönisch M, Mink A. Septal reconstruction with a polydioxanone plate (PDS).  FACE. 1999;  6 149-154
• 8 Boenisch M, Mink A. Clinical and histological results of septoplasty with a resorbable implant.  Arch Otolaryngol Head Neck Surg. 2000;  126 1373-1377
• 9 Hollinger J O, Battistone G. Biodegradable bone repair materials.  Clin Orthop Relat Res. 1986;  207 290-305
• 10 Nolst Trenité G J. Implantaten in een groeiend neustussenschot [Ph.D. dissertation]. Swets&Zeitlinger, Amsterdam 1984: 99-107
• 11 Boenisch M, Hajas T, Nolst Trenité G J. Influence of polydioxanone foil on growing septal cartilage after surgery in an animal model. New aspects of cartilage healing and regeneration.  Arch Facial Plast Surg. 2003;  5 316-319