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

Zita Jessop Orcid Logo, Adam Hague, Thomas Dobbs, Kenneth J. Stewart, Iain Whitaker

Frontiers in Surgery, Volume: 8

Swansea University Authors: Zita Jessop Orcid Logo, Thomas Dobbs, Iain Whitaker

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Abstract

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 s...

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Published in: Frontiers in Surgery
ISSN: 2296-875X
Published: Frontiers Media SA 2021
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URI: https://cronfa.swan.ac.uk/Record/cronfa60386
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first_indexed 2022-07-05T14:58:35Z
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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. 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spelling v2 60386 2022-07-05 Facial Cartilaginous Reconstruction—A Historical Perspective, State-of-the-Art, and Future Directions 0184f610b62d649a59dad304e48ea03b 0000-0003-2886-9165 Zita Jessop Zita Jessop true false d18101ae0b4e72051f735ef68f45e1a8 Thomas Dobbs Thomas Dobbs true false 830074c59291938a55b480dcbee4697e Iain Whitaker Iain Whitaker true false 2022-07-05 PMSC 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. Journal Article Frontiers in Surgery 8 Frontiers Media SA 2296-875X facial reconstruction, cartilage, tissue engineering, regenerative medicine, plastic and reconstructivesurgery 16 8 2021 2021-08-16 10.3389/fsurg.2021.680186 MINI REVIEW article. COLLEGE NANME Medicine COLLEGE CODE PMSC Swansea University Other Research reported in this study was supported by the Medical Research Council (MR/N002431/1), The Royal College of Surgeons of England, The British Association of Plastic, Reconstructive, and Aesthetic Surgeons (BAPRAS), The Scar Free Foundation and the Fulbright Commission. ZJ and TD were funded by the Welsh Clinical Academic Training (WCAT) Fellowship. 2022-08-16T13:16:57.5340057 2022-07-05T15:46:41.1444146 Swansea University Medical School Medicine Zita Jessop 0000-0003-2886-9165 1 Adam Hague 2 Thomas Dobbs 3 Kenneth J. Stewart 4 Iain Whitaker 5 60386__24457__002669ed09b74db589a05fb9e1ba61d4.pdf 60386.VOR.fsurg-08-680186.pdf 2022-07-05T15:59:21.8948399 Output 612798 application/pdf Version of Record true This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). true eng http://creativecommons.org/licenses/by/4.0/
title Facial Cartilaginous Reconstruction—A Historical Perspective, State-of-the-Art, and Future Directions
spellingShingle Facial Cartilaginous Reconstruction—A Historical Perspective, State-of-the-Art, and Future Directions
Zita Jessop
Thomas Dobbs
Iain Whitaker
title_short Facial Cartilaginous Reconstruction—A Historical Perspective, State-of-the-Art, and Future Directions
title_full Facial Cartilaginous Reconstruction—A Historical Perspective, State-of-the-Art, and Future Directions
title_fullStr Facial Cartilaginous Reconstruction—A Historical Perspective, State-of-the-Art, and Future Directions
title_full_unstemmed Facial Cartilaginous Reconstruction—A Historical Perspective, State-of-the-Art, and Future Directions
title_sort Facial Cartilaginous Reconstruction—A Historical Perspective, State-of-the-Art, and Future Directions
author_id_str_mv 0184f610b62d649a59dad304e48ea03b
d18101ae0b4e72051f735ef68f45e1a8
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author_id_fullname_str_mv 0184f610b62d649a59dad304e48ea03b_***_Zita Jessop
d18101ae0b4e72051f735ef68f45e1a8_***_Thomas Dobbs
830074c59291938a55b480dcbee4697e_***_Iain Whitaker
author Zita Jessop
Thomas Dobbs
Iain Whitaker
author2 Zita Jessop
Adam Hague
Thomas Dobbs
Kenneth J. Stewart
Iain Whitaker
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institution Swansea University
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publisher Frontiers Media SA
college_str Swansea University Medical School
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hierarchy_top_title Swansea University Medical School
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hierarchy_parent_title Swansea University Medical School
department_str Medicine{{{_:::_}}}Swansea University Medical School{{{_:::_}}}Medicine
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description 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.
published_date 2021-08-16T13:16:54Z
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