Bone Substitute in the Multi Traumatized Nasal Septum Reconstruction
Information source: University Hospital, Bordeaux
ClinicalTrials.gov processed this data on August 23, 2015 Link to the current ClinicalTrials.gov record.
Condition(s) targeted: Nasal Septum
Intervention: Rhinoplasty (Device)
Phase: Phase 2
Status: Completed
Sponsored by: University Hospital, Bordeaux Official(s) and/or principal investigator(s): Ludovic LE TAILLANDIER de GABORY, Dr, Principal Investigator, Affiliation: CHU Bordeaux
Summary
The aim of this project is to evaluate the safety and efficacy of the biomaterial made of
HAP/TCP (BCP, Kasios®), in septoplasties of multi traumatized human nose. The use of this
biomaterial will avoid the graft sampling and we expect it to be a good substitute to
support the nasal pyramid while favouring the respiratory epithelium regeneration. Thus,
that would confirm previous in vitro and in vivo studies.
Clinical Details
Official title: Multicentric Pilot, Clinical Study of a Bone Substitute Safety and Efficacy in the Multi Traumatized Nasal Septum Reconstruction
Study design: Endpoint Classification: Safety Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
Primary outcome: SafetyEpithelial cells affinity
Secondary outcome: Performance with Internal and external nasal shape assessmentPerformance with Functional Performance Assessment
Detailed description:
Five to ten percent of the post-traumatic septo-rhinoplasties require a total reconstruction
of the septal skeleton. This surgery requires using autologous bone graft (iliac, costal, or
parietal). However these swabs include surgical risks, have a particular morbidity non
negligible and particular quality imperfections (resorption level, texture, shape,
integration) requiring a complex and long lasting shaping before implantation. To avoid the
using of bone graft, a large scale of products has been developed to propose a synthetic
bone substitute as a support for bone reconstruction. The bone substitute, BCP, made of
hydroxyl apatite (HAP) and tricalcium phosphate (TCP), is thus largely used in orthopaedics,
and CE marked in numerous indications (like sinus lift). The stake is to validate that it
can be used in septo-rhino-plasties. This septic zone presents characteristics which
required in vitro and in vivo studies, showing that the conclusions are a good
biocompatibility of BCP for human epithelial cells and in septal area of rabbits and sheep.
The ultimate step to validate this concept consists in conducting a pilot clinical study on
25 patients with the indication of septoplasties to verify its safety and efficacy in
clinical conditions. This study will have an 18 months inclusion period and 6 months of
follow up. The principal objective is to assess the HAP/TCP biomaterial safety and to
confirm clinically and histologically the good affinity of human epithelial cells for this
material. Secondary objective is to demonstrate that the restoration of the normal nasal
anatomy with the material re-establishes the nasal respiratory shape and function. Clinical
data, questionnaires, and photos will be collected pre operatively and at day 4, 10, and
month 2 and 6 after surgery. The endonasal biopsy and fiberoptic endoscopy will be realised
at 2 and 6 months post operatively and will be supplementary to the routine care protocol of
the surgeon.
Eligibility
Minimum age: 18 Years.
Maximum age: 60 Years.
Gender(s): Both.
Criteria:
Inclusion Criteria:
- Men and women between 18 and 60
- Indication of tissue replacement in a nasal septum, which skeleton is lacking or non
usable for patients having:
- Paradoxal nasal obstruction with saddle nose type III and IV or flabby nose
- Nasal obstruction with an obstacle caused by a moved multifracture skeleton
- Written informed consent
- Patient with social insurance
Exclusion Criteria:
- Post-menopausal women : lack of efficient contraception (intra uterine dispositive or
contraceptive pill)
- Breast feeding or pregnant women
- HIV or VHB or VHC seropositive subject
- Inflammatory or infectious active rhino sinusitis
- Nasal an sinus surgery or trauma ended from less than 8 months
- Toxic medicated Rhinitis to vasoconstrictors
- Diabetic : all type of diabetes (without or with therapy)
- Non treated cardiac disease
- Any contra indication to surgery
- Any contra indication to the biomaterial use like evolutive infection, bone disease
or local necrosis
- Radiotherapy antecedent of the cephalic and cervical extremity
- Local or regional therapy with corticoids currently, or stopped from less than 2
months
- Patient participating to another study with an exclusion period still going on during
pre-inclusion period
Locations and Contacts
Service d'Oto-rhino-laryngologie - Clinique St Augustin, Bordeaux 33074, France
Service d'Oto-rhino-laryngologie et Chirurgie cervico-faciale - CHU de Bordeaux, Bordeaux 330176, France
Service d'Oto-rhino-laryngologie - Hôpital Dupuytren, Limoges 87042, France
Additional Information
Starting date: September 2011
Last updated: March 17, 2015
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