A team of ENT surgeons from the Toulouse University Hospital grafted, in September, on the nasal partition of the 50-year-old patient, a biomaterial graft, after having put her in nanny on her forearm. A world premiere that opens up perspectives.
by Philippe Gagnebet (Toulouse, correspondent)
“I breathe better, I still feel the smell of coffee in the morning, I revisited almost normally.” For Karine (she wants to remain anonymous), 50, life has just resumed after a single surgery. More than ten years after being treated for cancer of the nasal pits (epidermoid carcinoma) by radiotherapy and chemotherapy, this resident of Tarn is the first patient in the world to have benefited from a nasal graft manufactured in synthetic biomaterial and made on a printer 3D.
The feat was carried out by the ENT and cervico-facial surgery teams of the Toulouse University Hospital and the Claudius-Regaud Institute, within the Toulouse oncopole. At their head, Professor Agnès Dupret-Bories and Doctor Benjamin Vairel treat all cancers in the mouth, tongue or facial skin.
In this specific case, the patient had lost, following heavy treatments in 2013, a large part of her nose as well as the previous part of her palace. For more than four years, she lived without a nose, faced with chess of nasal reconstruction by grafting of skin shreds and a difficulty in supporting the wearing of a facial prosthesis (epithesis).
In 2020, Agnès Dupret-Bories, CNRS researcher at the Interuniversity Research and Material Engineering Center (CIRIMAT), who studies biomaterials, comes into contact with a young Thésard student in Belgium, Islam Bouabaz-Abdeljalil. With Cerhum company, based in Liège, it has already tested synthetic implants on a patient’s cheekbones.
Can the operation succeed on the whole of a nose? How to revascularize the implanted nose? With what materials and under what aesthetic conditions? It is these questions that the team comes up against. But, with the total agreement of the patient, the decision to try the operation was made at the end of 2021.
graft of a new type
“The first challenge was to make a graft of a new type, medically and technologically,” said Agnès Dupret-Bories. Cerhum already intervened on facial bone reconstruction, from unique parts. “Our parts are made with 3D printers and the so -called stereography technique, the most precise, allowing to integrate porosities, channels for blood vessels”, specifies Valentin Henriet, clinical engineer in Cerhum.
Made with hydroxyapatitis, a mineral species component of dental enamel and bones, the part presents itself as a complex scaffolding. It is indeed necessary that, in this “hollow labyrinth, the cells and the tissues can colonize”, details Valentin Henriet. That the transplant takes between the nasal partition and the graft. “For its shape and size, we have worked on the patient’s surgical data, which we have been following for a long time,” said Doctor Vairel.
You have 50.46% of this article to read. The continuation is reserved for subscribers.