Individualized, Additively Manufactured Drug-Releasing External Ear Canal Implant for Prevention of Postoperative Restenosis: Development, In Vitro Testing, and Proof of Concept in an Individual Curative Trial

被引：11

作者：

Matin-Mann, Farnaz ^{[1
]}

Gao, Ziwen ^{[1
,2
]}

Schwieger, Jana ^{[1
,2
]}

Ulbricht, Martin ^{[3
]}

Domsta, Vanessa ^{[3
]}

Senekowitsch, Stefan ^{[3
]}

Weitschies, Werner ^{[3
]}

Seidlitz, Anne ^{[3
,4
]}

Doll, Katharina ^{[5
]}

Stiesch, Meike ^{[5
]}

Lenarz, Thomas ^{[1
,2
]}

Scheper, Verena ^{[1
,2
]}

机构：

[1] Hannover Med Sch, Dept Otorhinolaryngol Head & Neck Surg, Lower Saxony Ctr Biomed Engn Implant Res & Dev NI, Stadtfelddamm 34, D-30625 Hannover, Germany

[2] Cluster Excellence Hearing4all EXC 1077 1, D-30625 Hannover, Germany

[3] Univ Greifswald, Ctr Drug Absorpt & Transport, Inst Pharm, Dept Biopharm & Pharmaceut Technol, D-17489 Greifswald, Germany

[4] Univ Duesseldorf, Inst Pharmaceut & Biopharmaceut, D-40225 Dusseldorf, Germany

[5] Hannover Med Sch, Clin Dent Prosthet & Biomed Mat Sci, D-30625 Hannover, Germany

来源：

PHARMACEUTICS | 2022年 / 14卷 / 06期

关键词：

ear canal stenosis; personalized implant; drug-eluting implant; additive manufacturing; preoperative workflow; external auditory canal; ACUTE OTITIS-EXTERNA; TOPICAL CIPROFLOXACIN/DEXAMETHASONE; COCHLEAR IMPLANT; CIPROFLOXACIN; STENOSIS; MANAGEMENT; DELIVERY; IMPEDANCE; SILICONE;

D O I：

10.3390/pharmaceutics14061242

中图分类号：

R9 [药学];

学科分类号：

1007 ;

摘要：

Postoperative restenosis in patients with external ear canal (EEC) atresia or stenosis is a common complication following canaloplasty. Our aim in this study was to explore the feasibility of using a three dimensionally (3D)-printed, patient-individualized, drug ((dexamethasone (DEX)), and ciprofloxacin (cipro))-releasing external ear canal implant (EECI) as a postoperative stent after canaloplasty. We designed and pre-clinically tested this novel implant for drug release (by high-performance liquid chromatography), biocompatibility (by the MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay), bio-efficacy (by the TNF-alpha (tumor necrosis factor-alpha)-reduction test (DEX) and inhibition zone test (for cipro)), and microbial contamination (formation of turbidity or sediments in culture medium). The EECI was implanted for the first time to one patient with a history of congenital EEC atresia and state after three canaloplasties due to EEC restenosis. The preclinical tests revealed no cytotoxic effect of the used materials; an antibacterial effect was verified against the bacteria Staphylococcus aureus and Pseudomonas aeruginosa, and the tested UV-irradiated EECI showed no microbiological contamination. Based on the test results, the combination of silicone with 1% DEX and 0.3% cipro was chosen to treat the patient. The EECI was implantable into the EEC; the postoperative follow-up visits revealed no otogenic symptoms or infections and the EECI was explanted three months postoperatively. Even at 12 months postoperatively, the EEC showed good epithelialization and patency. Here, we report the first ever clinical application of an individualized, drug-releasing, mechanically flexible implant and suggest that our novel EECI represents a safe and effective method for postoperatively stenting the reconstructed EEC.

引用

页数：20

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