Ear reconstruction through tissue engineering.

For decades, reconstructive surgery of the auricle has presented a challenge to surgeons. An immense number of publications now document the efforts to develop and improve techniques designed to provide reasonable shape and functionality. Since the early 1990s, tissue engineering has become increasingly popular in the field of reconstructive surgery. In particular, when an in-vitro-manufactured auricular-shaped cartilage implant was implanted on the back of a nude mouse, reconstructive surgeons were intrigued and patients' expectations were raised. However, almost 20 years after tissue engineering was defined by Langer and Vacanti [Science 1993;260:920-926] as: 'an interdisciplinary field that applies the principles of engineering and life sciences toward the development of biological substitutes that restore, maintain, or improve tissue function or a whole organ', only single case reports have been published. These reports detail the clinical application of in-vitro-manufactured cartilage for reconstructive procedures in the head and neck. The present article describes the fundamentals and potential of tissue engineering in reconstructive surgery of the auricle, and highlights the limitations that prevent its current clinical application. Copyright 2010 S. Karger AG, Basel.