medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2023-059medsovet-7505Research ArticleХИРУРГИЧЕСКАЯ ОТОРИНОЛАРИНГОЛОГИЯSURGICAL OTORHINOLARYNGOLOGYВозможности закрытия перфорации перегородки носа: от прошлого к будущемуPossibilities for nasal septum perforation healing: from the past to the futurehttps://orcid.org/0000-0001-7734-6892ЛобачеваВ. В.LobachevaV. V.

Лобачева Виктория Викторовна, ассистент кафедры болезней уха, горла и носа Института клинической медицины имени Н.В. Склифосовского 

 119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 2 

Viktoria V. Lobacheva, Assistant of the Department of Ear, Throat and Nose Diseases of the Sklifosovsky Institute of Clinical Medicines

8, Bldg. 2, Trubetskaya St., Moscow, 119991, Russia 

viktoria.loba4ewa@ya.ruhttps://orcid.org/0000-0001-7414-1293СвистушкинВ. М.SvistushkinV. M.

Свистушкин Валерий Михайлович, д.м.н., профессор, заведующий кафедрой болезней уха, горла и носа Института клинической медициныимени Н.В. Склифосовского, директор клиники болезней уха, горла и носа 

 119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 2 

Valery М. Svistushkin, Dr. Sci. (Med.), Professor, Head of the Department of Ear, Throat and Nose Diseases of the Sklifosovsky Institute of Clinical Medicines, Director of the Ear, Throat and Nose Diseases Clinic 

 8, Bldg. 2, Trubetskaya St., Moscow, 119991, Russia 

svvm3@yandex.ruhttps://orcid.org/0000-0002-3700-7367ЗолотоваА. В.ZolotovaA. V.

Золотова Анна Владимировна, к.м.н., доцент кафедры болезней уха, горла и носа Института клинической медицины имени Н.В. Склифосовского 

 119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 2 

Anna V. Zolotova, Cand. Sci. (Med.), Associate Professor of the Department of Ear, Throat and Nose Diseases of the Sklifosovsky Institute of Clinical Medicines 

 8, Bldg. 2, Trubetskaya St., Moscow, 119991, Russia 

zolotova.anna.vl@gmail.comhttps://orcid.org/0000-0002-8552-1395СвистушкинМ. В.SvistushkinM. V.

Свистушкин Михаил Валерьевич, к.м.н., ассистент кафедры болезней уха, горла и носа Института клинической медицины имени Н.В. Склифосовского 

 119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 2 

Mikhail V. Svistushkin, Cand. Sci. (Med.), Assistant of the Department of Ear, Throat and Nose Diseases of the Sklifosovsky Institute of Clinical Medicines 

 8, Bldg. 2, Trubetskaya St., Moscow, 119991, Russia 

svistmih@live.ruhttps://orcid.org/0000-0002-0051-3792ШевчикЕ. А.ShevchikE. A.

Шевчик Елена Александровна, к.м.н., доцент кафедры болезней уха, горла и носа Института клинической медицины имени Н.В. Склифосовского 

 119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 2 

Elena А. Shevchik, Cand. Sci. (Med.), Associate Professor of the Department of Ear, Throat and Nose Diseases of the Sklifosovsky Institute of Clinical Medicines 

 8, Bldg. 2, Trubetskaya St., Moscow, 119991, Russia 

elena.shevchik@gmail.comhttps://orcid.org/0000-0003-2464-0742ТычкинаИ. А.TychkinaI. A.

Тычкина Ирина Андреевна, студент 

 119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 2 

 Irina A. Tychkina, Student 

 8, Bldg. 2, Trubetskaya St., Moscow, 119991, Russia 

tychkina010203@mail.ruПервый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)РоссияSechenov First Moscow State Medical University (Sechenov University)Russian Federation20230705202307112117Copyright © Лобачева В.В., Свистушкин В.М., Золотова А.В., Свистушкин М.В., Шевчик Е.А., Тычкина И.А., 20232023Лобачева В.В., Свистушкин В.М., Золотова А.В., Свистушкин М.В., Шевчик Е.А., Тычкина И.А.Lobacheva V.V., Svistushkin V.M., Zolotova A.V., Svistushkin M.V., Shevchik E.A., Tychkina I.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/7505

 

Лечение перфораций перегородки носа остается сложной проблемой оториноларингологии. В статье обсуждается применение различных методов восстановления перфорации перегородки носа (ППН), описаны виды и варианты хирургического лечения в историческом аспекте. Данные операции имеют ряд недостатков, таких как сложность взятия материала, риск развития воспалительной реакции и образование фиброзной ткани при дегенерации трансплантата, а также другие послеоперационные осложнения, приводящие к рецидиву заболевания. Проведен краткий обзор эффективности различных аллои аутотрансплантатов, применяемых с целью устранения дефекта перегородки носа. Проанализированы публикации в зарубежной литературе по разработке и применению методов регенеративной медицины с целью устранения перфорации перегородки носа. Достижения результата зависят от используемых технологий и вида импланта для регенерации тканей. Выделяют отдельное использование стромальных клеток, скаффолдов, факторов роста или их комбинаций. Подобный подход позволяет восстановить поврежденную ткань за счет целенаправленной и контролируемой дифференцировки клеток, сопровождающейся синтезом межклеточного матрикса и снижением воспалительных процессов. На данный момент в доклинических и клинических исследованиях обращают на себя особое внимание прогениторные клетки стромального происхождения. Чаще всего применяются мезенхимальные стромальные клетки (МСК) костного мозга, жировой и других тканей. При имплантации в поврежденную область регенераторный эффект мезенхимальных стромальных клеток реализуется через секрецию широкого спектра противовоспалительных медиаторов, цитокинов и трофических факторов. Положительные эффекты от клеточной терапии данного типа клеток не должны ассоциироваться с дифференцировкой имплантированных клеток в клетки поврежденных тканей. Описано применение различных материалов для лечения ППН с оценкой их эффективности и дальнейшей перспективы.

The article discusses application of various methods for nasal septum perforation healing (NSP). The types and options of surgical treatment in the historical aspect are described. These operations have a number of disadvantages, such as: the complexity of the material taking, the risk of inflammatory reaction and scar formation, as well as other postoperative complications leading to a relapse of the disease. Effectiveness of various allo- and autografts that used to restore the defect of the nasal septum is observed. Publications of regenerative medicine methods to eliminate perforation of the nasal septum are analyzed. Implantation of stromal cells, scaffolds; growth factors or their combinations is used. Such approaches make possible the restoration of the damaged tissue due to targeted and controlled cell differentiation, accompanied by the synthesis of the intercellular matrix and a decrease in inflammatory processes. In preclinical and clinical studies, special attention is paid to stromal cells. Mesenchymal stromal cells (MSCs) of bone marrow, adipose and other tissues are most often used. The regenerative effects of mesenchymal stromal cells are realized through the secretion of a wide range of anti-inflammatory mediators, cytokines and trophic factors, the positive effects of cell therapy of this type of cells should not be associated with the differentiation of implanted cells into cells of damaged tissues. The use of various materials for the treatment of NSP is also described with an assessment of their effectiveness and future prospects.

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The authors declare that there are no conflicts of interest present.