Innovative Approaches in Microtia Treatment: Advancements in Tissue Engineering and Scaffold Design.

Abstract

Facial symmetry is paramount in societal perceptions of attractiveness, with symmetric faces receiving higher ratings. This is particularly relevant for individuals with microtia, a congenital condition affecting external ear formation, who often experience psychosocial challenges such as anxiety and depression. Auricular prostheses and High-density porous polyethylene (MEDPOR^®) offer an aesthetic solution. However, they are related to disadvantages like color mismatches, periodic replacement, and skin infections. Currently, the Nagata technique, regarded as the "gold standard" for microtia treatment, involves a two-step surgical procedure using autologous rib cartilage to reconstruct the auricle. Despite its widespread use, this method is highly invasive and associated with significant risks, including chronic pain, skin necrosis, and variable aesthetic outcomes dependent on the surgeon's skill. Tissue engineering presents a novel approach to microtia treatment, focusing on three core principles: creating a temporary scaffold for cellular support, selecting appropriate cells for seeding, and optimizing the regeneration process through molecular enhancements. This review discusses a novel perspective for microtia treatment with innovative methodologies that seek to improve aesthetic and functional outcomes, mainly through advancements in tissue engineering and scaffold fabrication techniques.