A surgeon in China says he
has constructed an extra nose out of a man's rib cartilage and implanted it
under the skin of his forehead to prepare for a transplant in probably the
first operation of its kind.
Surgeon Guo Zhihui at Fujian Medical University Union Hospital in China's southeastern province of Fujian spent nine months cultivating the graft for a 22-year-old man whose nose was damaged.
The striking images of the
implant — with the nostril section facing diagonally upward on the left side of
the man's forehead — drew widespread publicity after they began to circulate in
Chinese media this week. Guo plans to cut the nose from the forehead while
leaving a section of skin still connected, and then rotate and graft it into
position in a later operation.
"We were just
interested in helping the man and did not expect it would stir up this much
attention," Guo said in an interview Friday with The Associated Press.
Surgeons previously have
used cartilage to help rebuild noses in their proper position and are
experimenting with growing new ones from stem cells on other parts of the body,
such as a forearm. But this was the first known case of building a nose on a
forehead.
Alexander Seifalian, a
professor of nanotechnology and regenerative medicine at University College
London who has worked on transplants using stem cells, said implanting the nose
graft in the forehead makes sense because the skin there has the same "structure
and texture" as that of a nose.
However, he said it was
unclear why the Chinese team built the nose on the forehead rather than in its
proper position. A nose graft grown from stem cells would be prepared on
another body part first, but this operation is using existing cartilage,
Seifalian said.
"They could have made
the nose and just put it on the nose, not in the forehead," Seifalian
said. "I don't know why they put it there."
However, Seifalian noted
that he had not seen any scientific information on the Chinese operation and
was just going by media reports.
The patient lost part of his
nose in an accident in August 2012 and did not immediately have any
reconstruction surgery because he couldn't afford it, Guo said. An infection
later ate away much of his nose cartilage, he said.
Guo said his team examined
what remained of the nose and concluded there would be little chance of viably
grafting cartilage there, instead building the nose on the forehead. When the
new nose is rotated into position and grafted, it will at first have its own
blood supply from links to the forehead, before developing new blood vessels.
Later surgery will smooth out all of the skin.
The team first expanded skin
on the man's forehead for more than three months before using rib cartilage to
build the nose bridge. Lastly, Guo's team built the nostrils.
"We sculpted the nose
three-dimensionally, like carpenters," he said.
Source: AP
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