- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01234415
Bone Substitute in the Multi Traumatized Nasal Septum Reconstruction (NASEPT)
March 17, 2015 updated by: University Hospital, Bordeaux
Multicentric Pilot, Clinical Study of a Bone Substitute Safety and Efficacy in the Multi Traumatized Nasal Septum Reconstruction
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.
Study Overview
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.
Study Type
Interventional
Enrollment (Actual)
26
Phase
- Phase 2
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
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Bordeaux, France, 330176
- Service d'Oto-rhino-laryngologie et Chirurgie cervico-faciale - CHU de Bordeaux
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Bordeaux, France, 33074
- Service d'Oto-rhino-laryngologie - Clinique St Augustin
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Limoges, France, 87042
- Service d'Oto-rhino-laryngologie - Hôpital Dupuytren
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Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years to 60 years (Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
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
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Patient
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Rhinoplasty is performed under general anaesthesia; the duration is 1 to 2 hours.
The surgical approach for implantation of the biomaterial is external rhinoplasty.
The incision is made at the columella (base of nose) and becomes internal for the scar to be as unobtrusive as possible.
The septum skeleton is then destroyed in order to place the synthetic biomaterial.
The biomaterial is remodelled in order to have a natural external aspect of the nose.
The incision is closed and the wicks are put in place in the nose for 4 days.
A cast and a sticker will be put in place after surgery to maintain properly the biomaterial.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Safety
Time Frame: up to 6 months after surgery
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Frequency and severity of expected Adverse and Severe Adverse Events, as material extrusion, infection (wall abscess), and chronic pathological inflammatory reaction, pain, epistaxis.
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up to 6 months after surgery
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Epithelial cells affinity
Time Frame: up to 6 months after surgery
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macroscopic mucous membrane integrity (ciliated cells), absence of perforation, pathological analyses of biopsy to research sub epithelial infiltration, respiratory epithelial differentiation markers (HES, MOVAT pentachrome), immunohistochemistry (AB against cytokeratines 7, 8, 19, UEA1, MUC5AC) and MEB, MET analyses.
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up to 6 months after surgery
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Performance with Internal and external nasal shape assessment
Time Frame: month 2 and 6 after surgery.
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Photography and fiberoptic endoscopy
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month 2 and 6 after surgery.
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Performance with Functional Performance Assessment
Time Frame: pre operatively and post operatively at day 4, 10, and month 2 and 6 after surgery.
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NOSE and RHINO quality of life questionnaires Clinical data, questionnaires, and photos will be collected pre operatively and post operatively at day 4, 10, and month 2 and 6 after surgery.
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pre operatively and post operatively at day 4, 10, and month 2 and 6 after surgery.
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Ludovic LE TAILLANDIER de GABORY, Dr, CHU Bordeaux
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start
September 1, 2011
Primary Completion (Actual)
November 1, 2014
Study Completion (Actual)
November 1, 2014
Study Registration Dates
First Submitted
November 2, 2010
First Submitted That Met QC Criteria
November 2, 2010
First Posted (Estimate)
November 4, 2010
Study Record Updates
Last Update Posted (Estimate)
March 18, 2015
Last Update Submitted That Met QC Criteria
March 17, 2015
Last Verified
March 1, 2015
More Information
Terms related to this study
Keywords
Other Study ID Numbers
- CHUBX 2010/16
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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