One-Year Results of Ear Reconstruction with 3D Printed Implants

• Published in: Yonsei medical journal Vol. 65; no. 8; pp. 456 - 462
• Main Authors: Kim, Mijung, Kim, Yun Jung, Kim, Young Seok, Roh, Tai Suk, Lee, Eun-Ju, Shim, Jin-Hyung, Kang, Eun Hye, Kim, Min Ji, Yun, In Sik
• Format: Journal Article
• Language: English
• Published: Korea (South) Yonsei University College of Medicine 01.08.2024; 연세대학교의과대학
• Subjects: Adolescent; Adult; Congenital Microtia - surgery; Ear, External - abnormalities; Ear, External - surgery; Female; Humans; Male; Original; Plastic Surgery Procedures - methods; Polyesters; Printing, Three-Dimensional; Prostheses and Implants; Tissue Scaffolds; Tomography, X-Ray Computed; Treatment Outcome; Young Adult; 의학일반; reconstructive surgical procedures; three-dimensional; Microtia; tissue scaffold; polycaprolactone; printing
• ISSN: 0513-5796; 1976-2437; 1976-2437
• DOI: 10.3349/ymj.2023.0444

External ear reconstruction has been a challenging subject for plastic surgeons for decades. Popular methods using autologous costal cartilage or polyethylene still have their drawbacks. With the advance of three-dimensional (3D) printing technique, bioscaffold engineering using synthetic polymer draws attention as an alternative. This is a clinical trial of ear reconstruction using 3D printed scaffold, presented with clinical results after 1 year. From 2021 to 2022, five adult patients with unilateral microtia underwent two-staged total ear reconstruction using 3D printed implants. For each patient, a patient-specific 3D printed scaffold was designed and produced with polycaprolactone (PCL) based on computed tomography images, using fused deposition modeling. Computed tomography scan was obtained preoperatively, within 2 weeks following the surgery and after 1 year, to compare the volume of the normal side and the reconstructed ear. At 1-year visit, clinical photo was taken for scoring by two surgeons and patients themselves. All five patients had completely healed reconstructed ear at 1-year follow-up. On average, the volume of reconstructed ear was 161.54% of that of the normal side ear. In a range of 0 to 10, objective assessors gave scores 3 to 6, whereas patients gave scores 8 to 10. External ear reconstruction using 3D printed PCL implant showed durable, safe results reflected by excellent volume restoration and patient satisfaction at 1 year postoperatively. Further clinical follow-up with more cases and refinement of scaffold with advancing bioprinting technique is anticipated. The study's plan and results have been registered with the Clinical Research Information Service (CRIS No. 3-2019-0306) and the Ministry of Food and Drug Safety (MFDS No. 1182).