Ideal scaffold design for total ear reconstruction using a three‐dimensional printing technique

Abstract

Ear reconstruction using three-dimensional (3D) printing technique has been considered as a good substitute for conventional surgery, because it can provide custom-made 3D framework. However, there are difficulties with its application in clinical use. Researchers have reported 3D scaffolds for ear cartilage regeneration, but the designs of the 3D scaffolds were not appropriate to be used in surgery. Hence, we propose the design of an ideal 3D ear scaffold for use in ear reconstruction surgery. Facial computed tomography (CT) images of the unaffected ear were extracted using a "segmentation" procedure. The selected data were converted to a 3D model and mirrored to create a model of the affected side. The design of 3D model was modified to apply to Nagata's two-stage surgery. Based on the 3D reconstructed model, a 3D scaffold was 3D printed using polycaprolactone. The 3D scaffold closely resembled the real cartilage framework used in current operations in terms of ear anatomy.To account for skin thickness, the 3D scaffold was made 4 mm smaller than the real ear. Furthermore, 2 mm pores were included to allow the implantation of diced cartilage to promote regeneration of the cartilage. 3D printing technology can overcome the limitations of previous auricular reconstruction methods. Further studies are required to achieve a functional and stable substitute for auricular cartilage and to extend the clinical use of the 3D-printed construct. Additionally, the ethical and legal issues regarding the transplantation of 3D-printed constructs and cell culture technologies using human stem cells remain to be solved. FIGURE 1. The "segmentation" procedure. The contralateral unaffected ear was extracted from other tissue using the "segmentation" procedure.

Modification of the cartilaginous framework for autologous ear reconstruction: Construction of a stable complete ring framework with grander highs and lows

“…The pedantic nature to perfect the framework and to have recognizable anatomical features is driven by both patients and the innovative biotechnologies. The advent of stem cell-seeded 3D scaffolds may negate the need to harvest and carve autologous cartilage but these technologies are not yet realized or within financial capabilities 3,4,25,26 . Great effort and endeavor are invested internationally to improve autologous ear reconstruction, whether to minimize or render unnecessary the process of cartilage harvest, or to refine the ear shape.…”

Tissue engineering applications in otolaryngology—The state of translation

“…Heatmap representing the proportion of publications by year that utilized specific translational research methodologies from construct characterization to human trial to investigate otologic tissue engineering 15,25‐35,38‐43,45,46,107‐144 …”

Ear Cartilage Inference for Reconstructive Surgery with Convolutional Mesh Autoencoders

“…For a baseline comparison, we compare a scaled version of the soft tissue to the ground truth cartilage mesh. All soft tissue meshes were scaled by approximately 93%, equivalent to reducing the mesh by 1.5mm to allow for skin thickness [19]. The mean vertex error, and mean number of vertex intersections per mesh, are given in Table 1.…”