Auricular Reconstruction Research Articles

A study on the therapeutic effects of biplane skin dilator implantation in auricular reconstruction

This study aimed to compare the therapeutic effects of biplane skin dilator implantation with those of conventional skin dilator implantation in auricular reconstruction. A total of 137 patients with microtia who met the inclusion criteria from January 2020 to April 2021 were retrospectively selected. Sixty-three patients comprised the control group and were implanted with a skin expander using the conventional method. Seventy-four patients comprised the experimental group and were implanted with a skin expander using the biplane method. Non-parametric tests were used to compare the down-moving distance of the skin dilator between the experimental group and the control group. There was a statistically significant difference in the down-moving distance of the skin dilator between the experimental group and the control group (P < 0.05). The chi-square test showed no significant difference in postoperative complications between the experimental group and the control group (P > 0.05). Moreover, there was no significant difference in the satisfaction rate of patients and their families between the experimental group and the control group (P > 0.05). In this study, the treatment effect of biplane skin dilator implantation was better than that of conventional skin dilator implantation.

The use of preauricular skin flaps in the treatment of ear malignancy in elderly patients

The ear is one of the face areas most affected by skin cancers, and the surgical reconstruction is often challenging because of tumor- and patient-related factors. Reconstructive options are essentially skin flaps and grafts or their combinations. The use of preauricular translocation (PAT) flap for auricular reconstructions is constantly increasing. This retrospective study reports the comparison between the PAT flap and the full-thickness skin grafts (FTSGs) for surgical auricular defect reconstruction in elderly population (≥65years) that typically shows poor compliance in the postoperative wound care management. A total of 52 FTSGs (Group A) and 39 PAT (Group B) were performed between April 2007 and July 2020. The aim was to investigate, compare, and define advantages and disadvantages of both techniques. Visual Analogue Scale (VAS) was used to evaluate the overall patients' satisfaction. The mean surgical and healing times were longer in Group A (p<0.05). No complications occurred in the PAT group, and all the flaps survived. In the FTSG group, the overall complication rate was 17.3% (four partial and three total graft failure, and two graft infections). T test was used to compare the VAS scores: Patients with PAT flap were more satisfied than those with FTSG (p<0.05). Preauricular translocation flap is a reproducible, safe, and quick option for auricular defects reconstruction in the ≥65years population, associated with an easier patient management, high patient satisfaction, and excellent aesthetic result.

107 The Role of Tissue Engineering in Auricular Reconstruction: A Critical Review

Abstract Aim Despite several decades of research in tissue engineering, reconstructing a 3D human-sized ear that can stand the test of time has remained a challenge. Autologous cartilage reconstruction remains the main treatment choice despite the associated morbidity. Progress in the field has been made and several studies have used tissue-engineered implants in immunocompetent animals with promising results. Method This study critically reviews and assesses the characteristics that make auricular reconstruction so challenging and how far research has come in addressing the following: mechanical properties; vascularisation; immune response; cell sourcing; surgical attachments; allografts; and cost. Results The question is whether tissue engineering will realistically replace autologous cartilage reconstruction in the short-term, or will advances in other areas, outlined in this article, manage to provide suitable and aesthetically accurate scaffolds. Conclusions Advances in tissue engineering are slowly progressing and utilise advances in both biomaterial design and 3D bioprinting to try and address the challenges of auricular reconstruction. Tissue engineering is still a promising solution to auricular reconstruction but still requires further research before becoming a reality.

Psychosocial status of patients with unilateral and bilateral microtia before auricular reconstruction surgery

ObjectiveMicrotia can profoundly influence health-related quality of life. The aim of this study was to investigate the psychosocial status of children and adolescents with unilateral and bilateral microtia before reconstruction surgery. MethodsEighty-six patients with microtia from Peking Union Medical College Hospital (54 with unilateral microtia and 32 with bilateral microtia) responded to structured interviews before reconstruction surgery. The 3 clinically validated questionnaires were the Piers-Harris Children's Self-concept Scale (PHCSS), the Social Anxiety Scale for Children (SASC), and the Children's Loneliness Scale (CLS). Scores from the PHCSS and SASC were compared with Chinese norms. The total scores of the unilateral and bilateral groups were compared for all three questionnaires. ResultsMales with unilateral and bilateral microtia had significantly different PHSCC scores than norms (both P < 0.05), and male patients overall had a total score that was 10.61 ± 2.20 points lower than female patients overall. Patients who were 7–9 years-old in the unilateral group and 10 to 13 years-old in the bilateral group had lower total PHSCC scores than norms of the same age (both P < 0.05). There was no significant difference between patients and norms in the 14-16 years-old group. The SASC scores of patients were significantly higher than the norms (P < 0.05). The CLS score was significantly lower in the unilateral group than in the bilateral group (50.17 ± 14.63 vs. 61.38 ± 13.24, P < 0.05), but these two groups did not significantly differ in PHCSS and SASC scores. ConclusionCompared to Chinese norms, children with unilateral and bilateral microtia had lower self-concept, especially males and those who were 7–13 years-old. Patients with microtia also had increased social anxiety and loneliness. Patients with bilateral microtia were more likely to report loneliness than those with unilateral microtia.

Chondrocyte-laden GelMA hydrogel combined with 3D printed PLA scaffolds for auricle regeneration

The current gold standard for auricular reconstruction after microtia or ear trauma is the autologous cartilage graft with an autologous skin flap overlay. Harvesting autologous cartilage requires an additional surgery that may result in donor area complications. In addition, autologous cartilage is limited and the auricular reconstruction requires complex sculpting, which requires excellent clinical skill and is very time consuming. This work explores the use of 3D printing technology to fabricate bioactive artificial auricular cartilage using chondrocyte-laden gelatin methacrylate (GelMA) and polylactic acid (PLA) for auricle reconstruction. In this study, chondrocytes were loaded within GelMA hydrogel and combined with the 3D-printed PLA scaffolds to biomimetic the biological mechanical properties and personalized shape. The printing accuracy personalized scaffolds, biomechanics and chondrocyte viability and biofunction of artificial auricle have been studied. It was found that chondrocytes were fixed in the PLA auricle scaffolds via GelMA hydrogels and exhibited good proliferative properties and cellular activity. In addition, new chondrocytes and chondrogenic matrix, as well as type II collagen were observed after 8 weeks of implantation. At the same time, the transplanted auricle complex kept full and delicate auricle shape. This study demonstrates the potential of using 3D printing technology to construct in vitro living auricle tissue. It shows a great prospect in the clinical application of auricle regeneration.

Utilization of Alexandrite Laser for Hair Removal in Pediatric Auricular Reconstruction.

Auricular reconstruction with autologous rib cartilage involves using a soft tissue envelope to cover the cartilage framework. In patients with a low hairline, hair-bearing skin may be incorporated on the reconstructed ear, creating a difficult and conspicuous aesthetic problem. A retrospective chart review was conducted to summarize and share the experience of using the Candela GentleMax Pro 755-nm alexandrite laser system (Candela Corp) in children following auricular reconstruction. Nine patients received laser hair removal via the alexandrite laser system with good results. The number of completed sessions ranged from 1 to 5. The procedures were completed without the need for premedication or procedural sedation. Laser hair removal with an alexandrite laser system was safe, fast, and effective. With multistage auricular reconstruction, it was feasible to incorporate laser hair removal between the stages.

Facial Cartilaginous Reconstruction-A Historical Perspective, State-of-the-Art, and Future Directions.

Importance: Reconstruction of facial deformity poses a significant surgical challenge due to the psychological, functional, and aesthetic importance of this anatomical area. There is a need to provide not only an excellent colour and contour match for skin defects, but also a durable cartilaginous structural replacement for nasal or auricular defects. The purpose of this review is to describe the history of, and state-of-the-art techniques within, facial cartilaginous surgery, whilst highlighting recent advances and future directions for this continually advancing specialty.Observations: Limitations of synthetic implants for nasal and auricular reconstruction, such as silicone and porous polyethylene, have meant that autologous cartilage tissue for such cases remains the current gold standard. Similarly, tissue engineering approaches using unrelated cells and synthetic scaffolds have shown limited in vivo success. There is increasing recognition that both the intrinsic and extrinsic microenvironment are important for tissue engineering and synthetic scaffolds fail to provide the necessary cues for cartilage matrix secretion.Conclusions and Relevance: We discuss the first-in-man studies in the context of biomimetic and developmental approaches to engineering durable cartilage for clinical translation. Implementation of engineered autologous tissue into clinical practise could eliminate donor site morbidity and represent the next phase of the facial reconstruction evolution.

New strategies for base frame fabrication in microtia reconstruction

The base frame provides a stable support for the helix, antihelix, and tragus–antitragus complex in microtia reconstruction, and this support is vital to attain a highly defined outline for a reconstructed auricle. The success of base frame sculpting depends on appropriate treatment of the cartilage, mainly the sixth and seventh costal cartilages, which may have different characteristics. The aim of this study was to demonstrate the relevant details for base frame fabrication under various scenarios. Between 2016 and 2019, a total of 352 patients with microtia underwent autologous auricular reconstruction. Concerning the different sizes and characteristics of the costal cartilage used for the base frame reconstruction, we describe the related methods for fabrication and introduce corresponding strategies for proper management. We found that 90% of the patients responded at follow-up, and 76% of them were satisfied with the cosmetically refined auricle with harmonious integrity. The elaborate design and appropriate utilization of costal cartilage for base frame sculpting is one of the most significant and fundamental processes in microtia reconstruction. It contributes to achieving a clearly defined outline of the auricle with harmonious integrity, which is as important as the other projected subunits.

Contribution of perichondrium to the mechanical properties of auricular cartilage

The poor mechanical strength of tissue-engineered auricular cartilage which is possibly due to the lack of perichondrium limits its application in auricular reconstruction surgery. However, there is insufficient research and no reliable data to support this. This study aims to investigate the contribution of perichondrium to the mechanical strength of auricular cartilage under loading. Rabbit auricular cartilage was harvested and classified into two groups. The perichondrium was removed in Group A and was left intact in Group B. Young’s modulus, stress relaxation slope, and relaxation amout were analyzed through tensile and compressive tests using a material testing machine. Group B exhibited significantly higher Young’s modulus in both the tensile and compressive tests (p < 0.05), lower relaxation slope (p < 0.05 in tensile test, p = 0.65 in compressive test), and lower relaxation amout (p < 0.05 in tensile test, p < 0.01 in compressive test). Our results showed that the perichondrium has a definite contribution to the mechanical properties of ear cartilage. This study may provide new insights to researchers focusing on improving the mechanical strength of tissue-engineered auricular cartilage.

Advancements in the treatment of unfavorable auricular reconstruction.

Advancements in the treatment of unfavorable auricular reconstruction.

Tissue Engineering Auricular Cartilage: A Review of Auricular Cartilage Characteristics and Current Techniques for Auricular Reconstruction

Microtia and anotia are congenital auricular anomalies that negatively impact the psychosocial development of those affected. Because the auricular cartilage is a type of elastic cartilage that lacks regenerative capacity, any notable defect in its structure requires a surgical approach to reconstruct the auricle. While there are several reconstructive options available between alloplastic and prosthetic implants, autologous rib cartilage grafts remain the most commonly used treatment modality. Still, this widely used technique is accompanied by significant patient discomfort in a young child, and it carries additional risks secondary to the traumatic process of rib cartilage extraction, such as pneumothorax, chest wall deformities, and the final aesthetic results may not be ideal. To circumvent these limitations, tissue-engineering approaches have been employed to create a realistic-looking ear that mirrors the complex anatomy of the normal ear. This article provides an overall description of the ear’s anatomy and reviews the traditional management options for auricular reconstruction. The biochemical and biomechanical properties of human auricular cartilage are detailed as they relate to design criteria. In addition, a variety of cell sources, biocompatible scaffolds, scaffold-free techniques, mechanical and biological stimuli have been discussed. This review aims to identify knowledge gaps in the literature related to auricular cartilage characteristics and make recommendations to drive the field of auricular tissue engineering.

Selection and application in the approach of Bonebridge implantation for bilateral congenital malformation of external and middle ear: selection and application

Objective:According to whether auricle reconstruction has been performed before the implantation of Bonebridge, the different surgical plan of combination of ear reconstruction and hearing rehabilitation with Bonebridge were respectively applied for the individuals with congenital outer and middle ear malformation. The study aim to explore the feasibility of personalized comprehensive treatment of congenital outer and middle ear malformation. Methods:We developed individualized surgical plans of Bonebridge implantation and auricular reconstruction for 35 patients with bilateral external and middle ear malformation. Six patients underwent Bonebridge implantation on one side, and the post-auricular skin expander implantation on the other sidesimultaneously; seven patients underwent Bonebridge implantation at the same time as the second stage of auricular reconstruction; twenty-two patients had their Bonebridge implantations performed after the reconstruction of the auricles. Results:No intraoperative complications occured in 35 patients. No facial paralysis, vertigo, tinnitus and cerebrospinal fluid leakage was reported. One patient had skin infection after Bonebridge implantation. The Bonebridge was removed and 7 months later and the Bonebridge implantation was re-performed on the same side. No complication occurred after 16 months of follow-up. Conclusion:According to the individual condition of the patients, different surgical plans of Bonebridge implantation and auricular reconstruction can be selected personally, which is beneficial to obtain the ideal aesthetic and hearing outcome.

Outcome of Auricular Reconstruction with Porous Polyethylene Frameworks: Our 10 Years of Experience with 113 Children and Adults.

This study evaluates the surgical outcome and patient benefit after auricular reconstruction with porous polyethylene frameworks and temporoparietal fascia flaps in both children and adults. A total of 161 patients who had undergone auricular reconstruction between 2003 and 2014 by doctors in our department were asked to answer both a validated health-related quality-of-life questionnaire (Glasgow Benefit Inventory or Glasgow Children's Benefit Inventory) and a questionnaire reporting satisfaction, complaints, and complications with the reconstructed pinna. Furthermore, postoperative surgical complications were recorded. A total of 113 patients (89 individuals older than 14 and 24 children under the age of 14) returned the questionnaires. About 80% of the patients were satisfied with the results of their auricular reconstruction. The main complaints concerned scars and the shape. Patients' quality of life was correlated with their postoperative aesthetic satisfaction. Thus, framework extrusion was the principal factor affecting patients' satisfaction, whereas treatable postoperative complications did not interfere with the overall quality of life. Interestingly, children indicated greater benefit from auricular reconstruction than older patients. With regard to the patient's feeling of being physically healthy after auricular reconstruction, partial pinna reconstruction and reconstruction without simultaneous hearing restoration should be very carefully considered. Auricular reconstruction using a porous polyethylene framework significantly increases the patients' health-related quality of life and leads to significant patient satisfaction, especially in the case of younger patients.

Management Strategy of Local Subcutaneous Effusion After Auricle Reconstruction.

Microtia is a severe congenital malformation of the external ear, and auricular reconstruction is still a challenge for plastic surgeons because of the complicated procedures and rare conditions. This study aimed to describe the location of subcutaneous effusion after auricular reconstruction and explore the clinical efficacy of the indwelling needle puncture drainage method in the treatment of local subcutaneous effusion. From January 2017 to December 2019, 1240 patients (1296 affected sides) who underwent auricular reconstruction using autogenous cartilage framework in the Plastic Surgery Hospital of Chinese Academy of Medical Science and Peking Union Medical College were selected. The local subcutaneous effusion occurred within 5 days after the drainage tube was removed, and the indwelling needle was used for puncture and drainage in the postoperative treatment. A total of 55 patients had subcutaneous effusion after the operation, including 24 cases with Nagata's method and 31 cases with the expanded single-flap method. One patient showed no obvious reduction after puncture and drainage by indwelling needle and improved after the secondary operation. Two patients had slight cartilage absorption. The remaining patients had good results. The method of the indwelling needle for puncture and drainage is easy to operate. The problem of local subcutaneous effusion after auricular reconstruction can be solved and good efficacy can be obtained.

Treatment effect of hemifacial dysplasia by injecting transplantation of autologous tissue in the second stage surgery for total auricle reconstruction

Objective: To observe the treatment effect of hemifacial dysplasia by injecting transplantation of autologous dermis and fat granules in the second stage surgery for total auricle reconstruction. Methods: From March 2013 to March 2018, 57 patients with unilateral microtia and mild-to-moderate hemifacial dysplasia were divided into concurrent treatment group (32 cases, including 13 females and 19 males and aged 6-33 years old with an average age of 12.5 years) and traditional treatment group (25 cases, including 10 females and 15 males and aged 6-21 years old with an average age of 11.3 years) according to the different surgical methods. Modified Nagata method of auricular reconstruction was chosen, in the second stage surgery (cranial ear angle plasty), patients in concurrent treatment group received the treatment of hemifacial dysplasia with autologous dermal and fat injection transplantation at the same time; Patients in traditional treatment group only received cranial ear angle plasty. Statistical analysis of the two groups of patients was carried out for the average operation time, the average length of hospital stay, the incidence of common complications and postoperative satisfaction rate. SPSS 21.0 software was used for statistical analysis. Results: The mean operation time of the concurrent treatment group (282.0±3.4)min was longer than that of the traditional treatment group (243.0±3.1)min, and the difference was statistically significant (t=9.884, P<0.05). There were no statistically significant differences in the average length of stay between the the concurrent treatment group (9.4±0.3)d and the traditional treatment group(9.5±0.2)d, t=0.256, P>0.05. There were no statistically significant differences in the incidence of common surgical complications between the concurrent treatment group (12.5%, 4/32) and the traditional treatment group(12.0%, 3/25), χ2=0, P>0.05. Postoperative satisfaction rate of the concurrent treatment group(90.6%, 29/32) was significantly higher than that of the traditional treatment group(56.0%, 14/25), the difference was statistically significant (χ2=9.081, P<0.05). Conclusions: Auricular reconstruction with treatment of hemifacial dysplasia should not significantly increase the average length of stay and the incidence of common complications compared with auricular reconstruction alone. Although the operation time is slightly extended, the scheme of concurrent treatment can reduce the times of operations, save medical resources and increase the satisfaction rate of patients.

Auricular reconstruction after Mohs micrographic surgery: analysis of 101 cases

BackgroundThe ear is a region that has a high prevalence of cutaneous carcinomas and several guidelines indicate Mohs micrographic surgery as the first-choice treatment in such cases. Although the technique allows maximum preservation of healthy tissue, many auricular surgical wounds constitute a challenge due to the peculiar local anatomy, with evident curves and reliefs. Auricular reconstruction should prioritize function before aesthetics, but without leaving the latter aside, since postoperative distortions can have a significant psychological impact. ObjectiveTo describe the authors’ experience in auricular reconstruction after Mohs surgery and to evaluate the most frequently used repair methods. MethodsRetrospective study of consecutive cases submitted to Mohs surgery and auricular reconstruction, over a period of 3 years. ResultsOne hundred and one cases were included and the most common repair method was primary closure (n = 35), followed by full-thickness skin graft (n = 30) and flaps (n = 24). In thirty cases, reconstruction methods were associated. Seven patients had complications (partial graft necrosis, postoperative bleeding or infection). Study limitationsRetrospective design and the absence of long-term follow-up of some cases. ConclusionsThe dermatologic surgeon should be familiarized with different options for auricular reconstruction. Primary closure and skin grafts were the most frequently used repair methods.

Auricular reconstruction: where are we now? A critical literature review.

Deformities of the external ear can affect psychosocial well-being and hearing. Current gold-standard reconstructive treatment is autologous costal cartilage grafting despite the vast morbidity profile. Tissue engineering using stem cells and 3D printing can create patient-specific reconstructed auricles with superior cosmetic outcomes and reduced morbidity. This review critically analyses recent and breakthrough research in the field of regenerative medicine for the pinna, considering gaps in current literature and suggesting further steps to identify whether this could be the new gold-standard. A literature review was conducted. PubMed (MEDLINE) and Cochrane databases were searched using key terms regenerative medicine, tissue engineering, 3D printing, biofabrication, auricular reconstruction, auricular cartilage, chondrocyte, outer ear and pinna. Studies in which tissue-engineered auricles were implanted into animal or human subjects were included. Exclusion criteria included articles not in English and not published within the last ten years. Titles, abstracts and full texts were screened. Reference searching was conducted and significant breakthrough studies included. 8 studies, 6 animal and 2 human, were selected for inclusion. Strengths and weaknesses of each are discussed. Common limitations include a lack of human studies, small sample sizes and short follow-up times. Regenerative medicine holds significant potential to improve auricular reconstruction. To date there are no large multi-centred human studies in which tissue-engineered auricles have been implanted. However, recent human studies suggest promising results, raising the ever-growing possibility that tissue engineering is the future of auricular reconstruction. We aim to continue developing knowledge in this field.

Temporoparietal Fascia Flaps in Children Under 15 Years of Age: An Anatomic Investigation and Its Clinical Implications in Auricular Reconstruction.

Background:The temporoparietal fascia (TPF) flap has been successfully used in the treatment of microtia with primary or secondary cases. The literature contains numerous studies about its structure and vascular anatomy in adults. However, it is rare to study its vasculature and characteristics in children.Methods:From September of 2013 to May of 2020, 188 patients with average age of 9.8 years (range, 5–14 years) underwent total ear reconstruction with costal cartilage in 67 patients (68 ears) or porous polyethylene framework in 121 patients (128 ears) using 196 TPF flaps. The TPF flap was most commonly used in second-stage operations to elevate the reconstructed auricle in the costal cartilage group. Contrastingly, the TPF flap was routinely used in the porous polyethylene framework group. The vascular pattern and characteristics of the TPF flap were evaluated during flap elevation.Results:Only 140/196 cases (71.4%) showed a typical pattern with the superficial temporal artery and the superficial temporal vein in this study; others (28.6%) were supplied by combinations of the posterior auricular artery or vein, occipital vein, diploic vein, and superficial artery or vein. Meanwhile, there are variants of the STA and posterior origin-superficial temporal artery, which originates posterior to the lobule beneath the cartilage remnant (3/196, 1.5%).Conclusion:Surgeons should inspect the pattern of the TPF flap thoroughly before elevation in children, because of the variety of the vessels and anatomic patterns of TPF.

Evaluation of respiratory system anomalies associated with microtia in a Chinese specialty clinic population

BackgroundMicrotia is a congenital malformation of the external ear often with one or more associated congenital anomalies. The purpose of this study was to identify the characteristics and prevalence of respiratory anomalies in patients with microtia, and clarify the importance of this association in the perioperative period of patients’ external ear reconstruction surgery. MethodsData were collected from 923 microtia patients between August 2017 and December 2020 in the Department of Auricular Reconstruction at the Plastic Surgery Hospital of Peking Union Medical College. Co-occurring respiratory anomalies were detected using chest computed tomography plus three-dimensional reconstruction and Chest X-ray. Physical examination was performed to assess the severity and type of microtia by trained clinicians. Fisher's exact test was used to analyze the relation between laterality of pulmonary underdevelopment and microtia type. ResultsAmong the 923 participants enrolled in the study, we identified 21 cases (2.3%) having respiratory system anomalies, consisting of 6 cases with pulmonary underdevelopment (28.6% of all anomalies of respiratory system detected), 2 cases with tracheal bronchus (9.5%), 1 case with tracheal diverticula (4.8%), 11 cases with lung bullae(52.4%), and 1 case with pulmonary azygos lobe (4.8%). The laterality of pulmonary underdevelopment was related to the type of microtia (difference between types, p < 0.05), as patients with concha-type remnant ear had pulmonary underdevelopment ipsilaterally. ConclusionsThis study represents the first detailed and thematic study of a association featured by microtia and respiratory anomalies. Characteristics and prevalence of respiratory anomalies was observed in a Chinese clinical microtia population. Early diagnosis of associated respiratory malformations had practical clinical significance for microtia patients, plastic surgeons and anesthesiologists. Future studies are required to improve understanding of this association and its cause.

203 Developing and Fine-Tuning Novel 3D-Printed Biodegradable Scaffolds to Promote Auricular Cartilaginous Regeneration for Surgical Implantation

Abstract Introduction Microtia, a congenital cartilaginous defect, poses major challenges in cosmetic surgery. Biodegradable polymers promote chondrogenesis, with promises of seeding cells into synthetic-polymer-implants for surgical fixation. However, existing polymers used in auricular reconstruction present limitations including inflammation, fibrosis, and extrusion. This study aimed to modulate the mechanical properties of the novel polylactic-acid/polyhydroxyalkanoate (PLA/PHA) blend by 3D-printing and hence, evaluate its suitability to the auricular microenvironment in developing next-generation reconstructs. Method Digitally defined PLA/PHA scaffolds were free-form 3D-printed at various infill densities and thicknesses. Through tensile testing, tensile moduli, yield point, maximum strength, tensile toughness, and stiffness were calculated, alongside Finite Element Analysis (FEA) and contact angle tests. Finally, preliminary cell seeding was conducted. Results Increasing infill densities of PLA/PHA scaffolds from 30%-60% significantly increased tensile moduli, yield point and maximum strength (P &amp;lt; 0.01). Tensile stiffness increased significantly with scaffold thicknesses between 1mm-2mm (P &amp;lt; 0.05). Cell studies showed promising proliferative activity. Conclusions The mechanical properties and structural stiffness of 3D-printed PLA/PHA scaffolds can be significantly tailored by altering infill density and thickness, respectively. The digitally defined interconnected pores within printed PLA/PHA scaffolds reduce stiffness mismatches between surgical-synthetic polymers and auricular cartilage, potentially promoting cell migration and nutrition transportation in future reconstructs.