Updated: Apr 7, 2021
Traumatic or congenital disabilities in the nasal tissue can cause severe functional impairments and aesthetic problems. Autogenous tissue is still considered the gold standard for nasal and craniofacial reconstruction. Materials such as polymers and metals, even autografts and allografts, often fail to imitate the complex 3D anatomy and biology of native tissues even with good clinical results. These limitations led to the development of new and less invasive techniques to reconstruct nasal cartilage, such as 3D bioprinting [1-3].
The nasal cartilage system comprises two alar cartilages, the nasal septum cartilage, two upper lateral cartilages, and some accessory cartilage components. The work on the nasal cartilages is more laborious than other cartilage types due to the small and complex structure. However, in recent years, computer technology has become an essential tool for surgeries on nasal cartilage. Its high efficiency, low cost, and ability to analyze and simulate organs and tissues, improving surgical planning and 3D printing, bring several benefits to this type of procedure, increasing surgical precision [3-5].
Geometric changes in the shape and size of the nasal tissue can be digitally calculated. The customized nasal implant can be produced by 3D printing technology and through virtual simulation software that design the desired reconstructed nasal shape. Thus, a 3D printed nasal graft would reach the nose shape with the minimized errors due to the coincidence of shape and size between the printed and designed objects .
In 2019, Yi and his team designed a nasal cartilage implant with a custom design manufactured via 3D printing injection of a hydrogel loaded with cells for augmentative rhinoplasty. In this study, an injection technique was established to fill the nasal implants’ internal architecture with a hydrogel derived from cartilage loaded with stem cells from human adipose tissue (hASCs). The projected nasal cartilage was implanted in the subcutaneous region of mice, showing the maintenance of the shape and structure and the remarkable formation of cartilaginous tissues for 12 weeks .
Figure 1: Subcutaneous implantation of the engineered nasal cartilage. (a) The construct is implanted in a dorsal subcutaneous region. (b) The retrieved implant after 12 weeks post-implantation .
Jodat et al. integrated nasal cartilage tissue construction with an electrochemical biosensor system to bring functional olfactory sensations to various airway disease biomarkers. The so-called electronic noses can be functionalized with odor receptor proteins to detect a wide range of odors and chemicals detectable by humans. The composition of these unstructured biosensors such as glass and flexible polymeric substrates facilitates their integration into living tissues and organs .
Figure 2: Schematic diagram showing the procedure of printing the nose .
1- Visscher, D.O.; Farré-Guasch, E.; Helder, M.N.; Gibbs,S.; Forouzanfar, T.; van Zuijlen, P.P.; Wolff, J. (2016). Advances in Bioprinting Technologies for Craniofacial Reconstruction. Trends in Biotechnology, 34(9), 700–710.
2- Cui, X.; Breitenkamp, K.; Finn, M.G.; Lotz, M.; D’Lima, D.D. (2012). Direct Human Cartilage Repair Using Three-Dimensional Bioprinting Technology. Tissue Engineering Part A, 18(11-12), 1304–1312.
3- Shi, B. & Huang, H. (2020). Computational technology for nasal cartilage-related clinical research and application. International Journal of Oral Science, 12(1).
4- Yi, H.-G.; Choi, Y.-J.; Jung, J.W.; Jang, J.; Song, T.-H.; Chae, S.; … Cho, D.-W. (2019). Three-dimensional printing of a patient-specific engineered nasal cartilage for augmentative rhinoplasty. Journal of Tissue Engineering, 10, 204173141882479.
5- Jodat, Y.A.; Kiaee, K.; Jarquin, D.V.; De la Garza Hernández, R.L.; Wang, T.; Joshi, S.; … Shin, S.R. (2020). A 3D‐Printed Hybrid Nasal Cartilage with Functional Electronic Olfaction. Advanced Science, 1901878.