Undifferentiated Human Adipose Tissue-Derived Stromal Cells Induce Mandibular Bone Healing in Rats [Original Article]

Undifferentiated Human Adipose Tissue–Derived Stromal Cells Induce Mandibular Bone Healing in Rats

Claudio Parrilla, MD, PhD; Nathalie Saulnier, PhD; Camilla Bernardini, PhD; Riccardo Patti, MS; Tommaso Tartaglione, MD; Anna Rita Fetoni, MD, PhD; Enrico Pola, MD, PhD; Gaetano Paludetti, MD; Fabrizio Michetti, MD; Wanda Lattanzi, MD, PhD

Arch Otolaryngol Head Neck Surg. 2011;137(5):463-470. doi:10.1001/archoto.2011.61

Objective  To test the osteo-regenerative potential of adipose tissue–derived stromal cells (ATSCs), an attractive human source for tissue engineering, in a rat model of mandibular defect. Human dermal fibroblasts (HDFs) were used as a differentiated cellular control in the study.

Design  The ATSCs and HDFs were isolated from human lipoaspirate and skin biopsy specimens, respectively. Cells were characterized in vitro and then adsorbed on an osteo-conductive scaffold to be transplanted in a mandibular defect of immunosuppressed rats. Naked unseeded scaffold was used as a negative control.

Main Outcome Measures  Bone healing was studied by computerized tomography and histologic analysis after 4, 8, and 12 weeks.

Results  Computed tomography showed that undifferentiated ATSCs induced successful bone healing of the mandible defect when transplanted in animals, compared with HDFs and negative controls. Histologic analysis demonstrated that the newly formed tissue in the surgical defect retained the features of compact bone.

Conclusion  Undifferentiated human ATSCs are suitable for cell-based treatment of mandibular defects, even in the absence of previous osteogenic induction in vitro.

Author Affiliations: Departments of Otolaryngology (Drs Parrilla, Fetoni, and Paludetti), Internal Medicine (Dr Saulnier), Radiology (Dr Tartaglione), Orthopaedics (Dr Pola), and Institute of Anatomy and Cell Biology (Drs Bernardini, Michetti, and Lattanzi and Mr Patti), Universit? Cattolica del Sacro Cuore, School of Medicine A. Gemelli, Rome, Italy; INSERM, Paris, France (Dr Saulnier); and Latium Muscular Skeletal Tissue Bank, Rome, Italy (Dr Michetti).

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Mandibular Distraction Osteogenesis in Infants Younger Than 3 Months [Original Article]

Published online January 17, 2011. Arch Facial Plast Surg May/Jun 2011 2011;13(3):173-179. Andrew R. Scott, MD; Robert J. Tibesar, MD; Timothy A. Lander, MD; Daniel E. Sampson, DDS, MD; James D. Sidman, MD

Author Affiliations: Department of Otolaryngology–Head & Neck Surgery, Tufts University School of Medicine, and Floating Hospital for Children, Tufts Medical Center, Boston, Massachusetts (Dr Scott); Pediatric ENT Associates (Drs Tibesar, Lander, and Sidman) and Department of Oral Surgery (Dr Sampson), Children's Hospitals and Clinics of Minnesota, Minneapolis; Department of Otolaryngology, University of Minnesota Medical School, Minneapolis (Drs Tibesar, Lander, and Sidman); and OMS Specialists, Anthony, Minnesota (Dr Sampson). Objectives To examine the long-term outcomes and complications in infants with upper airway obstruction and feeding difficulty who underwent bilateral mandibular distraction osteogenesis (MDO) within the first 3 months of life and to identify any preoperative characteristics that may predict the long-term outcome following early MDO intervention for airway obstruction.

Methods An institutional, retrospective medical chart review was performed. Inclusion criteria were bilateral MDO performed at an age younger than 3 months, with a minimum follow-up of 3 years. A quantitative outcome measures scale was developed, and patients were scored based on long-term postoperative complications as well as airway and feeding goals. Factors such as need for an additional surgical procedure were also considered.

Results Nineteen children were identified as having undergone MDO before 3 months of age and having more than 3 years of follow-up data. The mean age at distraction was 4.8 weeks (range, 5 days-12 weeks); the mean length of follow-up was 5.6 years (range, 37-122 months). Of these 19 patients, 14 had isolated Pierre Robin sequence (PRS) and 5 had syndromic PRS. All patients with isolated PRS had a good or intermediate long-term result. Infants with comorbidities such as developmental delay, seizures, or arthrogryposis had the poorest outcomes.

Conclusions Bilateral MDO is a relatively safe and effective means of treating airway obstruction and feeding difficulty in infants with PRS. The effects of this procedure, which carries a relatively low morbidity, persist through early childhood in most patients.

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