Chemical septoplasty using papain enzyme\u2014a feasibility study

Abstract

BackgroundThough surgery can correct nasal septal defects through a procedure called septoplasty, many people seek non-surgical options. Papain enzyme has been used in the past to lyse intervertebral disc and has shown to have a lytic effect on cartilage. Therefore, in this paper, the feasibility to use papain for septoplasty was studied.First, an in vitro study on chicken cartilage was done. Cartilage pieces were emerged in papain solution (5 mg/ml of papain in normal saline) and plain normal saline solution (as control) for 2 weeks at room and refrigeration temperatures. Then, the papain solution was injected in a formalin-fixed cadaver in the submucosal space around the nasal septal cartilage. The control group was injected with normal saline.ResultsThe treated group showed significant lysis with the disintegration of the cartilage, both in the in vitro and cadaver study.ConclusionThis study shows that papain can lyse cartilage. It also shows that submucosal injection of papain around nasal cartilage will lyse the septal cartilage. Based on prior experience with papain for disc herniation and the present study, it is worthwhile to further investigate this procedure using live animals.