The application and progress of tissue engineering and biomaterial scaffolds for total auricular reconstruction in microtia

Yeqian Huang; Hanxing Zhao; Yixi Wang; Siwei Bi; Kai Zhou; Hairui Li; Changchun Zhou; Yudong Wang; Wenqing Wu; Bo Peng; Jun Tang; Bo Pan; Baoyun Wang; Zhixing Chen; Zhengyong Li; Zhenyu Zhang

doi:10.3389/fbioe.2023.1089031

The application and progress of tissue engineering and biomaterial scaffolds for total auricular reconstruction in microtia

Front Bioeng Biotechnol. 2023 Sep 22:11:1089031. doi: 10.3389/fbioe.2023.1089031. eCollection 2023.

Authors

Yeqian Huang¹, Hanxing Zhao^{1

2}, Yixi Wang¹, Siwei Bi¹, Kai Zhou², Hairui Li², Changchun Zhou³, Yudong Wang¹, Wenqing Wu¹, Bo Peng^{1

2}, Jun Tang^{1

2}, Bo Pan⁴, Baoyun Wang^{1

2}, Zhixing Chen^{1

2}, Zhengyong Li^{1

2}, Zhenyu Zhang^{1

2}

Affiliations

¹ Department of Burn and Plastic Surgery, West China Hospital, Sichuan University, Chengdu, China.
² Department of Plastic Reconstructive and Aesthetic Surgery, West China Tianfu Hospital, Sichuan University, Chengdu, China.
³ National Engineering Research Center for Biomaterials, College of Biomedical Engineering, Sichuan University, Chengdu, China.
⁴ Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Abstract

Microtia is a congenital deformity of the ear with an incidence of about 0.8-4.2 per 10,000 births. Total auricular reconstruction is the preferred treatment of microtia at present, and one of the core technologies is the preparation of cartilage scaffolds. Autologous costal cartilage is recognized as the best material source for constructing scaffold platforms. However, costal cartilage harvest can lead to donor-site injuries such as pneumothorax, postoperative pain, chest wall scar and deformity. Therefore, with the need of alternative to autologous cartilage, in vitro and in vivo studies of biomaterial scaffolds and cartilage tissue engineering have gradually become novel research hot points in auricular reconstruction research. Tissue-engineered cartilage possesses obvious advantages including non-rejection, minimally invasive or non-invasive, the potential of large-scale production to ensure sufficient donors and controllable morphology. Exploration and advancements of tissue-engineered cartilaginous framework are also emerging in aspects including three-dimensional biomaterial scaffolds, acquisition of seed cells and chondrocytes, 3D printing techniques, inducing factors for chondrogenesis and so on, which has greatly promoted the research process of biomaterial substitute. This review discussed the development, current application and research progress of cartilage tissue engineering in auricular reconstruction, particularly the usage and creation of biomaterial scaffolds. The development and selection of various types of seed cells and inducing factors to stimulate chondrogenic differentiation in auricular cartilage were also highlighted. There are still confronted challenges before the clinical application becomes widely available for patients, and its long-term effect remains to be evaluated. We hope to provide guidance for future research directions of biomaterials as an alternative to autologous cartilage in ear reconstruction, and finally benefit the transformation and clinical application of cartilage tissue engineering and biomaterials in microtia treatment.

Keywords: 3D printing; auricular reconstruction; biomaterial scaffold; microtia; tissue engineering.

Publication types

Review

Grants and funding

This work was funded by Sichuan Science and Technology Program (2022YFS0197, 2022NSFSC0717, and 2022NSFSC1579), and the 1·3·5 Project for Disciplines of Excellence, West China Hospital, Sichuan University (ZYPY20003 and ZYPY20004).