A review of reconstruction of the burned ear

5 June 2017 | Lewis Dingle | PMFA - Facial Plastic Surgery, PMFA - General Plastic Surgery

The exposed location of the ear, combined with its thin skin and subcutaneous tissue makes it prone to full thickness burn injuries. As a result, deformity and disfigurement of the ear is a common sequelae of burns. This is a concise review of current treatment options for pinna reconstruction and new developments in the exciting field of tissue engineering. A summary of proposed classification systems for the burned ear is also presented, although individual cases will be unique requiring flexibility in treatment options. After discussing techniques for managing small helical defects, the authors review current techniques for reconstructing the cartilagenous framework of the ear including costal cartilage harvest and synthetic implants are reviewed, with their relative limitations and complications. The remainder of the article summarises the increasing potential of tissue engineering and 3D bioprinting. The use of chondrocyte and perichondria cell culture to produce autologous cartilage is presented alongside select studies discussing pluripotent and mesenchymal stem-induced cartilage formation. Current limitations in providing stable cartilage and the time taken to culture appropriate numbers of cells are highlighted. The authors discuss the use of biomaterials which have been used to act as a scaffold for transfer of cartilage-forming cells providing numerous references to detailed reviews of tissue engineering and biopolymers. Lastly the article addresses the exciting possibilities of 3D bioprinting which has the potential to produce patient-specific scaffolds designed to match defects and adapt to individual soft tissue limitations. This is a concise summary of reconstructive options for the burned ear. Although somewhat light on surgical technique and basic science of tissue engineering, it provides a starting point for those looking to understand current options and future directions of ear reconstruction. In addition, it provides a valuable list of references for the reader interested in tissue engineering and 3D bioprinted scaffolds for auricular reconstruction.