Bio-Engineering in Microtia Reconstruction: A Narrative Review

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.