Purpose of review
The reconstruction of cartilaginous craniofacial defects is ideally performed with analogous grafting material, such as autologous tissue. However, the use of autologous cartilage is limited by its finite availability and potentially suboptimal geometry to repair specific defects. Tissue engineering of human cartilage may provide the adequate supply of grafting and implant material for the reconstruction of cartilaginous facial defects. An update of the various cartilage tissue engineering methodologies is provided in this review.
The cartilage tissue engineering paradigm begins with the harvest of a small septal cartilage donor specimen. This is followed by the isolation and subsequent proliferation of chondrocytes and the seeding of these cells onto three-dimensional scaffolds. Neocartilage is created as pericellular substrate, is produced by the cells and deposited throughout the scaffold. Theoretically, the mature cartilage construct can be introduced back into the same patient for reconstruction of craniofacial defects. Initial steps of the cartilage tissue engineering protocol have been standardized; however, modifications of subsequent steps have shown the potential to profoundly impact tissue composition and strength, bringing the properties of cartilage constructs closer to those of native human septum.
The ability to engineer virtually limitless quantities of autologous cartilage could have a profound impact on facial plastic and reconstructive surgery. The strategies used to refine human cartilage culture techniques have successfully produced neocartilage constructs with biochemical and biomechanical properties approaching those of native septal tissue. With the steady progress achieved in recent years, there is great capacity for the proximate realization of surgically implantable tissue-engineered cartilage constructs.