Auricular reconstruction is a technically demanding procedure requiring significant surgical expertise, as the current gold standard involves hand carving of the costal cartilage into an auricular framework and re‐implantation of the tissue. 3D‐printing presents a powerful tool that can reduce technical demands associated with the procedure. Our group compared clinical, radiological, histological, and biomechanical outcomes in single‐ and two‐stage 3D‐printed auricular tissue scaffolds in an athymic rodent model. Briefly, an external anatomic envelope of a human auricle was created using DICOM computed tomography (CT) images and modified in design to create a two‐stage, lock‐in‐key base and elevating platform. Single‐ and two‐stage scaffolds were 3D‐printed by laser sintering poly‐L‐caprolactone (PCL) then implanted subcutaneously in five athymic rats each. Rats were monitored for ulcer formation, site infection, and scaffold distortion weekly, and scaffolds were explanted at 8 weeks with analysis using microCT and histologic staining. Nonlinear finite element analysis was performed to determine areas of high strain in relation to ulcer formation. Scaffolds demonstrated precise anatomic appearance and maintenance of integrity of both anterior and posterior auricular surfaces and scaffold projection, with no statistically significant differences in complications noted between the single‐ and two‐staged implantation. While minor superficial ulcers occurred most commonly at the lateral and superior helix coincident with finite element predictions of high skin strains, evidence of robust tissue ingrowth and angiogenesis was visible grossly and histologically. This promising preclinical small animal model supports future initiatives for making clinically viable options for an ear tissue scaffold.

中文翻译：

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用于耳朵重建的临床简化、3D 打印、生物相容性单阶段和两阶段组织支架的临床前评估。


耳廓重建是一项技术要求很高的手术，需要大量的外科专业知识，因为当前的黄金标准涉及将肋软骨手工雕刻成耳廓框架并重新植入组织。 3D 打印提供了一种强大的工具，可以减少与手术相关的技术要求。我们的小组比较了无胸腺啮齿动物模型中单阶段和两阶段 3D 打印耳廓组织支架的临床、放射学、组织学和生物力学结果。简而言之，使用 DICOM 计算机断层扫描 (CT) 图像创建了人类耳廓的外部解剖包膜，并修改了设计以创建两级锁键底座和升降平台。通过激光烧结聚左旋己内酯 (PCL) 3D 打印单级和两级支架，然后分别植入五只无胸腺大鼠的皮下。每周监测大鼠的溃疡形成、部位感染和支架变形，并在第 8 周时移植支架，并使用 microCT 和组织学染色进行分析。进行非线性有限元分析以确定与溃疡形成相关的高应变区域。支架表现出精确的解剖学外观，并保持了前后耳表面和支架投影的完整性，单阶段和两阶段植入之间的并发症没有统计学上的显着差异。虽然轻微的浅表溃疡最常发生在外侧和上耳轮，这与高皮肤应变的有限元预测一致，但在肉眼和组织学上都可以看到强大的组织向内生长和血管生成的证据。 这种有前途的临床前小动物模型支持未来为耳组织支架提供临床可行选择的举措。