Institute of Medical Sciences, Faculty of Medicine, Canterbury Christchurch University, Chatham Maritime, Kent, UK.
Facial Plastics, University Hospital Lewisham, Lewisham, UK.
Eur Arch Otorhinolaryngol. 2022 Feb;279(2):541-556. doi: 10.1007/s00405-021-06903-5. Epub 2021 Jun 2.
Deformities of the external ear can affect psychosocial well-being and hearing. Current gold-standard reconstructive treatment is autologous costal cartilage grafting despite the vast morbidity profile. Tissue engineering using stem cells and 3D printing can create patient-specific reconstructed auricles with superior cosmetic outcomes and reduced morbidity. This review critically analyses recent and breakthrough research in the field of regenerative medicine for the pinna, considering gaps in current literature and suggesting further steps to identify whether this could be the new gold-standard.
A literature review was conducted. PubMed (MEDLINE) and Cochrane databases were searched using key terms regenerative medicine, tissue engineering, 3D printing, biofabrication, auricular reconstruction, auricular cartilage, chondrocyte, outer ear and pinna. Studies in which tissue-engineered auricles were implanted into animal or human subjects were included. Exclusion criteria included articles not in English and not published within the last ten years. Titles, abstracts and full texts were screened. Reference searching was conducted and significant breakthrough studies included.
8 studies, 6 animal and 2 human, were selected for inclusion. Strengths and weaknesses of each are discussed. Common limitations include a lack of human studies, small sample sizes and short follow-up times.
Regenerative medicine holds significant potential to improve auricular reconstruction. To date there are no large multi-centred human studies in which tissue-engineered auricles have been implanted. However, recent human studies suggest promising results, raising the ever-growing possibility that tissue engineering is the future of auricular reconstruction. We aim to continue developing knowledge in this field.
外耳畸形会影响社交心理健康和听力。目前，自体肋软骨移植是金标准的重建治疗方法，尽管其发病率很高。利用干细胞和 3D 打印技术的组织工程可以创建具有更好美容效果和更低发病率的患者特异性重建耳廓。本综述批判性地分析了耳廓再生医学领域的最新突破性研究，考虑了当前文献中的空白，并提出了进一步的步骤，以确定这是否可能成为新的金标准。
进行了文献回顾。使用关键词“再生医学”、“组织工程”、“3D 打印”、“生物制造”、“耳廓重建”、“耳廓软骨”、“软骨细胞”、“外耳”和“耳轮”在 PubMed（MEDLINE）和 Cochrane 数据库中进行了检索。纳入了将组织工程化的耳廓植入动物或人体受试者的研究。排除标准包括非英文发表和发表时间不足十年的文章。筛选标题、摘要和全文。进行了参考文献检索，并纳入了重要的突破性研究。
选择了 8 项研究，其中 6 项为动物研究，2 项为人研究。讨论了每项研究的优缺点。常见的局限性包括缺乏人体研究、样本量小和随访时间短。
再生医学具有改善耳廓重建的巨大潜力。迄今为止，还没有进行过将组织工程化耳廓植入人体的大型多中心研究。然而，最近的人体研究表明了有希望的结果，这使得组织工程成为耳廓重建未来的可能性越来越大。我们旨在继续在这一领域发展知识。
