“组织工程耳”离我们还有多远？-3例组织工程软骨支架耳廓再造术的临床报告  

How far away are we to the tissue-engineering ear still？ --A clinical report on the 3 cases of ear reconstruction with tissue-engineering cartilage framework.

作　　者：蒋海越 Jiang Haiyue(team. Seventh Plastic Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100144, China)

机构地区：[1]中国医学科学院北京协和医学院整形外科医院耳整形再造一中心,北京100144

出　　处：《中华整形外科杂志》2018年第3期165-171,共7页Chinese Journal of Plastic Surgery

基　　金：首都临床特色应用研究专项课题（Z151100004015185）;中国医学科学院医学与健康科技创新工程项目（2017-12M-1-007）

摘　　要：利用组织工程技术进行耳廓再造一直是我们的重要研究方向之一，1997年曹谊林教授等报道了将人耳形组织工程软骨移植于裸鼠皮下的研究，之后科学家们在支架材料的制备和种子细胞的选择和培养等方面进行了探索。我们根据大量自体肋软骨耳廓再造的临床经验分析移植到受区后耳支架的营养环境及受力特征，并提出残耳软骨做种子细胞的可能性，与曹谊林基础研究团队合作，制备以残耳来源的种子细胞和PCL-PGA-PLA复合材料为支架的个性化组织工程软骨耳支架，于2014年完成了国际首例组织工程软骨支架耳廓再造手术，手术方法采用经典的皮肤扩张法耳再造技术。之后义相继实施了2例同类手术，以组织工程软骨支架植入时间为准，随访至今，第1例43个月，第2例28个月，第3例14个月。本文将详细报告3例患者的治疗过程及临床观察结果，为今后的研究提供参考。Since a long time ago, tissue engineering has always been one of our important research fields in ear reconstruction. Professor Yilin Cao et al published their paper＂ Transplantation of chondrocytes utilizing a polymer-cell construct to produce tissue-engineered cartilage in the shape of a human ear＂in 1997. Since then, the following studies have made some progress in the areas of seed cell culture and scaffold preparation. Depending on decades of clinical experiences of ear reconstruction with autologous rib cartilage framework, we analyzed the blood supply condition and mechanical properties of the fl＇amework after transplantation to the recipient area. And we put forward the idea of harvesting lnicrotia cartilage as the source of seed cells in Stage 1 surgery. Yilin Cao team, in cooperation with us, constructed the tissue- engineered cartilage framework in the shape of patient＇s normal ear with seed cells t^om microtic cartilage and PCL-PGA-PLA compound bioscaffold. We performed the world＇s first case of ear reconstruction with tissue-engineered framework in 2014. The surgical method was ear reconstruction with skin expansion. We treated 2 more cases using the same techniques in 2015 and 2016. Since the framework implantation, the first case has been followed up for 43 months, the second 28 months and the third lg months. We reported the treatment and clinical observations of the three cases in details as follows for clinical reterence.

关 键 词：组织工程 耳廓再造术 小耳畸形 

分 类 号：R318[医药卫生—生物医学工程]