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Autologous total auricular reconstruction requires an intricately sculpted, curved, and stacked cartilaginous framework implanted under healthy vascularized tissue. The ideal fixation technique would be readily available, easy to deploy, and free of complications. Commonly used sutures can fracture fragile pieces, inadequately maintain shape, or migrate. Steel wire can erode through soft tissues, extrude, fracture, or become infected. We successfully used 2-octyl cyanoacrylate alone to fixate an autologous costal cartilage framework designed for a total auricular reconstruction in an adult trauma patient. We had no sutures or wires in the final construct. The key aspects of our technique included the following: use of small aliquots, application only at cartilage-to-cartilage interfaces, use of temporary shaping (needles and lasso sutures), and avoidance of excess spillage of adhesive on any portion that would directly contact soft tissue. The framework was implanted into a prelaminated radial forearm free flap, which was then transferred to the head and neck region at a second stage. At two-year followup, the framework held satisfactory shape without any complications such as resorption, exposure, or infection.

A detailed; mission-level systems study has been performed to show the benefit resulting from engine performance gains that will result from NASA's In-Space Propulsion ROSS Cycle 3A NRA, Advanced Chemical Technology sub-topic. The technology development roadmap to accomplish the NRA goals are also detailed in this paper.NASA-Marshall and NASA-JPL have conducted mission-level studies to define engine requirements, operating conditions, and interfaces. Five reference missions have been chosen for this analysis based on scientific interest, current launch vehicle capability and trends in space craft size:• GTO to GEO, 4800 kg, delta-V for GEO insertion only -1830 m/s • Titan Orbiter with aerocapture, 6620 kg, total delta V -210 m/s, mostly for periapsis raise after aerocapture.• Enceladus Orbiter (Titan aerocapture) 6620 kg, delta V 2400 m/s.• Europa Orbiter, 2170 kg, total delta V 2600 m/s.• Mars Orbiter, 2250 kg, total delta V -1860 m/sThe figures of merit used to define the benefit of increased propulsion efficiency at the spacecraft level include propulsion subsystem wet mass, volume and overall cost.The objective of the NRA is to increase the specific impulse of pressure-fed earth storable bipropellant rocket engines to greater than 330 seconds with nitrogen tetroxide and monomothylhydrazine propellants and greater than 335 , seconds with nitrogen tetroxide and hydrazine. Achievement of the NRA goals will significantly benefit NASA interplanetary missions and other government and commercial opportunities by enabling reduced launch weight and/or increased payload. The study also constitutes a crucial stepping stone to future development, such as pump-fed storable engines.

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