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Narrative Review

Vol. 17 No. 1 (2019)

Bio-Engineering in Microtia Reconstruction: A Narrative Review

May 26, 2018


Introduction: Three-dimensional (3D) modeling and printing have become widely adopted in surgical fields, whether it be for pre-operative planning, production of prostheses, outcomes monitoring and even surgical training. Plastic and reconstructive surgeons have shown interest in using 3D technology in craniofacial reconstruction, in particular for microtia.  

Discussion: In patients with unilateral microtia, 3D modeling and printing of their normal contralateral ear to use as an intra-operative reference during costochondral or MedPor carving were preferred by surgeons to traditional 2D drawings as they provide the depth aspect of the ear and logistically save time. Combining tissue engineering with 3D modeling and printing by seeding chondrocytes onto a customized biodegradable ear framework is promising to restore aesthetics and obviates certain challenges of the autologous costochondral graft technique.

Conclusions and relevance: Microtia is a common congenital malformation and its current gold standard is technically challenging. As medicine is moving towards personalized medicine, 3D modeling and printing will definitely play a larger role in various surgical fields, including microtia reconstruction. Future studies will likely focus on refining the acquisition of images to produce 3D models, standardizing tissue engineering techniques and using bioprinting to produce external ears once the technology is clinically applicable.


  1. Lipson H. New world of 3-D printing offers "completely new ways of thinking": Q&A with author, engineer, and 3-D printing expert Hod Lipson. IEEE pulse. 2013;4(6):12-4.
  2. Ventola CL. Medical Applications for 3D Printing: Current and Projected Uses. Pharmacy and Therapeutics. 2014;39(10):704-11.
  3. Ursan ID, Chiu L, Pierce A. Three-dimensional drug printing: a structured review. Journal of the American Pharmacists Association : JAPhA. 2013;53(2):136-44.
  4. Schubert C, van Langeveld MC, Donoso LA. Innovations in 3D printing: a 3D overview from optics to organs. The British journal of ophthalmology. 2014;98(2):159-61.
  5. Gross BC, Erkal JL, Lockwood SY, Chen C, Spence DM. Evaluation of 3D printing and its potential impact on biotechnology and the chemical sciences. Analytical chemistry. 2014;86(7):3240-53.
  6. Banks J. Adding value in additive manufacturing: researchers in the United Kingdom and Europe look to 3D printing for customization. IEEE pulse. 2013;4(6):22-6.
  7. Mertz L. Dream it, design it, print it in 3-D: what can 3-D printing do for you? IEEE pulse. 2013;4(6):15-21.
  8. Janis JE. Essentials of Plastic Surgery 2nd Edition ed. St Louis, United States: Thieme Medical Publishers Inc; 2014. 1367 p.
  9. Jeon B, Lee C, Kim M, Choi TH, Kim S, Kim S. Fabrication of three-dimensional scan-to-print ear model for microtia reconstruction. The Journal of surgical research. 2016;206(2):490-7.
  10. Baluch N, Nagata S, Park C, Wilkes GH, Reinisch J, Kasrai L, et al. Auricular reconstruction for microtia: A review of available methods. Plastic surgery (Oakville, Ont). 2014;22(1):39-43.
  11. Schroeder MJ, Lloyd MS. Tissue Engineering Strategies for Auricular Reconstruction. The Journal of craniofacial surgery. 2017;28(8):2007-11.
  12. Chen HY, Ng LS, Chang CS, Lu TC, Chen NH, Chen ZC. Pursuing Mirror Image Reconstruction in Unilateral Microtia: Customizing Auricular Framework by Application of Three-Dimensional Imaging and Three-Dimensional Printing. Plastic and reconstructive surgery. 2017;139(6):1433-43.
  13. Flores RL, Liss H, Raffaelli S, Humayun A, Khouri KS, Coelho PG, et al. The technique for 3D printing patient-specific models for auricular reconstruction. Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery. 2017;45(6):937-43.
  14. Weissler JM, Sosin M, Dorafshar AH, Garcia JR. Combining Virtual Surgical Planning, Intraoperative Navigation, and 3-Dimensional Printing in Prosthetic-Based Bilateral Microtia Reconstruction. Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons. 2017;75(7):1491-7.
  15. Iyer K, Dearman BL, Wagstaff MJ, Greenwood JE. A Novel Biodegradable Polyurethane Matrix for Auricular Cartilage Repair: An In Vitro and In Vivo Study. Journal of burn care & research : official publication of the American Burn Association. 2016;37(4):e353-64.
  16. Cheng Y, Cheng P, Xue F, Wu KM, Jiang MJ, Ji JF, et al. Repair of ear cartilage defects with allogenic bone marrow mesenchymal stem cells in rabbits. Cell biochemistry and biophysics. 2014;70(2):1137-43.
  17. von Bomhard A, Veit J, Bermueller C, Rotter N, Staudenmaier R, Storck K, et al. Prefabrication of 3D cartilage contructs: towards a tissue engineered auricle--a model tested in rabbits. PloS one. 2013;8(8):e71667.
  18. Hohman MH, Lindsay RW, Pomerantseva I, Bichara DA, Zhao X, Johnson M, et al. Ovine model for auricular reconstruction: porous polyethylene implants. The Annals of otology, rhinology, and laryngology. 2014;123(2):135-40.
  19. Zhou G, Jiang H, Yin Z, Liu Y, Zhang Q, Zhang C, et al. In Vitro Regeneration of Patient-specific Ear-shaped Cartilage and Its First Clinical Application for Auricular Reconstruction. EBioMedicine. 2018;28:287-302.


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