Plastic Surgery Research Council
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HIGH-FIDELITY TISSUE ENGINEERING OF PATIENT-SPECIFIC AURICLES FOR RECONSTRUCTION OF PEDIATRIC MICROTIA: LONG-TERM RESULTS
Presenter: Alyssa J Reiffel, MD
Co-Authors: Brown BN; Hernandez KA; Perez JL; Campbell R; Boyko T; Zhou S; Bonassar LJ; Spector JA
Weill Cornell Medical College

INTRODUCTION: Autologous techniques for the reconstruction of pediatric microtia often result in suboptimal aesthetic outcomes and morbidity at the costal cartilage donor site. In previous work, we have reported the successful fabrication and short term implantation of biocompatible tissue-engineered (TE) auricular scaffolds by combining digital photogrammetry with CAD/CAM techniques. We now present our results after long-term in vivo implantation.

METHODS: Three-dimensional structures of normal pediatric ears were digitized and converted to virtual solids for mold design. Image-based synthetic reconstructions of these ears were fabricated from collagen type I hydrogels. Half were seeded with 2.5x10^7 bovine auricular chondrocytes. Cellular and acellular constructs were implanted subcutaneously in the dorsa of nude rats and harvested after 1 and 3mo.

RESULTS: Gross inspection revealed that acellular implants had significantly decreased in size by 1mo. Cellular constructs retained their contour/projection from the animals dorsa, even after 3mo. Post-harvest weight of cellular constructs was significantly greater than that of acellular constructs after 1mo (4.170.17g v. 0.800.07g, p<1x10-4) and 3mo (4.481.63g v. 0.690.03, p=0.046). Safranin O-staining revealed that cellular constructs demonstrated evidence of a self-assembled perichondrial layer and copious neocartilage deposition (Figure 1). Verhoeff staining of 1mo cellular constructs revealed de novo elastic cartilage deposition, which was even more extensive and robust after 3mo. The equilibrium modulus and hydraulic permeability of cellular constructs were not significantly different from native cartilage after 3mo (Figure 2).

CONCLUSIONS: We have developed high-fidelity, biocompatible, patient-specific TE constructs for auricular reconstruction which largely mimic the native auricle both biomechanically and histologically, even after an extended period of implantation. This strategy holds immense potential for durable patient-specific tissue engineered anatomically proper auricular reconstructions in the future.


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