Tissue Engineering

Abstract

External ear reconstruction for congenital deformity such as microtia or following trauma remains one of the greatest challenges for reconstructive plastic surgeons. The problems faced in reconstructing the intricate ear framework are highly complex. A durable, inert material that is resistant to scar contracture is required. To date, no material, autologous or prosthetic, is available that perfectly mimics the shapely elastic cartilage found in the ear. Current procedure involves autologous costal cartilage that is sculpted to create a framework for the overlying soft tissues. However, this is associated with donor-site morbidity, and few surgeons worldwide are skilled in the techniques required to obtain excellent results. Various alloplastic materials have therefore been used as a framework. However, a degree of immunogenicity and infection and extrusion are inevitable, and results are often disappointing. Tissue-engineered cartilage is an alternative approach but, despite significant progress in this area, many problems remain. These need to be addressed before routine clinical application will become possible. The current tissue-engineered options are fragile and inflexible. The next generation of auricular cartilage engineering is promising, with smart materials to enhance cell growth and integration, and the application of stem cells in a clinical setting. More recently, the authors' team designed the world's first entirely synthetic trachea composed of a novel nanocomposite material seeded with the patient's own stem cells. This was successfully transplanted in a patient at the Karolinska Hospital in Sweden and may translate into a tissue-engineered auricle in the future.

Role of Insulin-Transferrin-Selenium in Auricular Chondrocyte Proliferation and Engineered Cartilage Formation in Vitro

“…Cell-based tissue engineering offers promise in auricular construction [1]. Auricular chondrocyte appears to be the logical choice among the various cell types for auricular cartilage tissue engineering, as chondrocyte is the only single cell type that resides within cartilage and is solely responsible for the synthesis and turnover of the extracellular matrix (ECM).…”

Combining regenerative medicine strategies to provide durable reconstructive options: auricular cartilage tissue engineering

“…Constructs implanted into immune-competent animal models have been observed to undergo inflammation, fibrosis [ 75 ] and foreign body reaction [ 76 ]. This is particularly problematic with polymeric scaffolds, such as poly(lactic acid) or poly(glycolic acid) scaffolds, whose degradation products promote antigenicity [ 77 ]. In many cases, the unrelated cell sources produce immature neo-cartilage that is prone to degradation [ 6 , 78 ], is prone to calcification [ 5 , 79 ] and is easily breakable [ 80 – 82 ].…”

The potential role of regenerative medicine in the management of traumatic patients

“… 84 Regeneration of auricular cartilage, oral mucosa, tooth and periodontal tissue, and vocalcords are under investigation in several studies. 85 , 86 , 87 , 88 , 89 …”