Abstract
Aim
Despite several decades of research in tissue engineering, reconstructing a 3D human-sized ear that can stand the test of time has remained a challenge. Autologous cartilage reconstruction remains the main treatment choice despite the associated morbidity. Progress in the field has been made and several studies have used tissue-engineered implants in immunocompetent animals with promising results.
Method
This study critically reviews and assesses the characteristics that make auricular reconstruction so challenging and how far research has come in addressing the following: mechanical properties; vascularisation; immune response; cell sourcing; surgical attachments; allografts; and cost.
Results
The question is whether tissue engineering will realistically replace autologous cartilage reconstruction in the short-term, or will advances in other areas, outlined in this article, manage to provide suitable and aesthetically accurate scaffolds.
Conclusions
Advances in tissue engineering are slowly progressing and utilise advances in both biomaterial design and 3D bioprinting to try and address the challenges of auricular reconstruction. Tissue engineering is still a promising solution to auricular reconstruction but still requires further research before becoming a reality.