How could there be a nose on top of head?
We all have heard the expression “eyes on the back of one’s head”, but a nose on top of one’s head?
What the heck?
A Chinese doctor has apparently grown a new nose on top of a patient’s forehead. The patient had his nose damaged by an injury and then also ravaged by infection.
It makes perfect sense to bioengineer a new nose for the man, but it’s a puzzling story in this case for many reasons.
Why, for example, grow the nose on the man’s forehead instead of right where his nose is?
According to the Associated Press:
Surgeons previously have used cartilage to help rebuild noses in their proper position and are experimenting with growing new ones from stem cells on other parts of the body, such as a forearm. This was the first known case of building a nose on a forehead.
The notion of growing a new nose or ear to replace an injured one is backed by solid science, but why grow it on top of a forehead? This odd approach means the nose has to be moved and that the forehead must be injured to remove the nose.
Also, I wonder, why in this case did the doctor grow the nose with the nostrils up? This seems illogical as the openings could collect dust or water leaving the patient prone to infection.
Apparently the logic for growing the new nose on the head is that the skin on the forehead is similar to nose skin say as compared to the skin of the arm, which would have been more inconspicuous but have less nose-like skin.
There is also promise in engineering new body parts such as noses, ears, and even internal organs from stem cells.
One of the aspects of this news story on growing the nose, highlighted in this LA Times story, that I found most interesting is that the practice of fixing injured noses goes back to ancient times.
The Sushruta Samhita, a Sanskrit text, described the surgical tools, herbs and techniques necessary for nasal reconstructive surgery, and offered this bit of advice to practitioners: “Operation without trembling, fear, or doubt are always praiseworthy of the surgeon operating.”
The text is attributed to Sushruta, a physician who is believed to have lived about 600 BC.
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Hi Paul,
Thanks for posting this interesting story. I’ll have a shot at your questions:
(1) Why grow with the nostrils facing upwards?
The nostril end of the nose is the bit that is going to leave the biggest scar when the nose is surgically moved. So, scar minimization is the reason. Note, the nose is aligned with the hairline. Thoughtful surgeon.
(2) Why not grow the new nose where the mangled nose is located?
In a word, infection. The nose is a rather messy site to cultivate.
In a second word, cytokines. The damaged nose site is likely to have all sorts of chemical signalling going that might regulate the growth of a new nose in ways that are not desirable. ie, the old site is a site for a mature nose where signalling would be geared towards homeostasis — whereas that is not the signalling you need to grow a new nose. To put it more compactly, a doctor could manipulate the growing conditions at the forehead location without being lead by the nose.
Much for the same reasons, I think it is difficult to grow hyaline cartilage in an arthritic knee… but still sometimes possible.
Of course, no one should believe a word I say because I’m not a doctor, I’m not a cell biologist, I’m not even a biologist. So I look forward to seeing what your expert readers think.
Actually, I have a question of my own:
Would that nose be a drug and would it ever be approved by the FDA?