Biocompatible Materials in Otorhinolaryngology and Their Antibacterial Properties

Abstract

For decades, biomaterials have been commonly used in medicine for the replacement of human body tissue, precise drug-delivery systems, or as parts of medical devices that are essential for some treatment methods. Due to rapid progress in the field of new materials, updates on the state of knowledge about biomaterials are frequently needed. This article describes the clinical application of different types of biomaterials in the field of otorhinolaryngology, i.e., head and neck surgery, focusing on their antimicrobial properties. The variety of their applications includes cochlear implants, middle ear prostheses, voice prostheses, materials for osteosynthesis, and nasal packing after nasal/paranasal sinuses surgery. Ceramics, such as as hydroxyapatite, zirconia, or metals and metal alloys, still have applications in the head and neck region. Tissue engineering scaffolds and drug-eluting materials, such as polymers and polymer-based composites, are becoming more common. The restoration of life tissue and the ability to prevent microbial colonization should be taken into consideration when designing the materials to be used for implant production. The authors of this paper have reviewed publications available in PubMed from the last five years about the recent progress in this topic but also establish the state of knowledge of the most common application of biomaterials over the last few decades.

Keywords: antimicrobial action; biomaterials; nanomaterials; osteosynthesis; tissue engineering; voice prosthesis.

Figure 1

Chemical structures of poly(glycolic acid) (PGA), poly(lactic acid) (PLA), and poly(lactide-co-glycolide) (PLGA). (n: number of repeat units in PLA and PGA; x and y: number of lactic and glycolic units in PLGA, respectively). * another unit of PGA/PLA.

Figure 2

Schematic illustration showing the degradation of PLGA co-polymer and the PGA and PLA monomers. As a result, carbon dioxide and water are finally produced.

Figure 3

(A): pure silicone electrode array without DEX (0%); (B): electrode array containing 1% DEX (16 ng/day delivery rate); (C): electrode array containing 10% DEX (49 ng/day delivery rate). Adapted from an open-access source: [36].

Figure 4

Nonabsorbable nasal packing Merocel (Medtronic Inc., Minneapolis, MN, USA). Panel (A) presents compressed, dehydrated sponge. Panel (B) shows the sponge decompressed, 30 s after hydration with saline. Material from the authors’ collection.

Figure 5

Mometasone-loaded (A) spring-like Propel™ sinus implant expands when placed into the sinus mucosa (B), thus keeping the middle meatus open and, hence, promoting mucous drainage and wound healing. Adapted from an open-access source: [15].

Figure 6

Nasal drug concentration versus time, obtained after administration of nasal sprays and drug-eluting implants. Nasal sprays show rapid clearance of the drug from the nasal mucosa (panel (A)) as compared to locally acting implants (panel (B)). Adapted from an open-access source: [15].

Figure 7

Surgical templates printed using a 3D printer personalized to the patient’s anatomical features, fitted on CT scan and oral scanner. Used to facilitate and speed up the surgical procedure of dental implants. Material from the authors’ collection.

Figure 8

Figure presents Provox voice prostheses. Panel (A) shows a completely new prosthesis. Panel (B) shows the voice prosthesis after 26 months of use. Its surface is covered with microbial biofilm. Material from the authors’ collection.

Figure 9

Middle-ear prosthesis for ossicular reconstruction made of ABS polymer. Adapted from an open-access source: [158].