Reconstruction of auricular cartilage using tissue-engineering techniques

Reconstructive surgery of the nose and the auricle frequently requires grafting from different sites of cartilage as donor material. Typically, grafts for nasal reconstruction are obtained from within the nose whenever possible; alternatively, cartilage can be obtained from the auricle or the rib. Auricular reconstruction procedures usually involve the harvesting of rib cartilage when large parts of the auricle have to be reconstructed. However depending on the underlying disease, harvesting might not be possible to a sufficient degree, eg, after multiple reconstruction efforts or in burn or malformation surgery. Also a severe donor site morbidity has to be taken into account in the case of harvesting rib cartilage. Tissue engineering is an evolving area of research, with the aim of growing tissue in vitro that can be used for reconstructive purposes. This article reviews the current state of the art of tissue engineering procedures of cartilage for reconstruction of the auricle and is determined to answer the question why the technique has not yet found its way into daily clinical routine in otolaryngology in contrast to its performance in orthopaedic surgery.