Ear Cartilage Reconstruction: From Regenerative Medicine to Reconstructive Surgery

Innovations in ear reconstruction in the developing medical field have resulted in various advantages and disadvantages. In addition to rib autologous ear cartilage reconstruction, cartilage differentiation is achieved using stem cell technologies, or cartilage is constructed using tissueengineering-based systems from various natural and artificial materials. Intercalarily, autologous rib ear cartilage reconstruction is routinely used; it is a field that is constantly being developed, from stem cells and cell culture systems to natural and artificial biomaterials and tissue engineering-based systems. It is estimated that 3D scaffold systems created using tissue engineering approaches will continue to be popular for a long time in terms of both shaping and cellularization. The differentiation potential of stem cells, the mechanical strength, biocompatibility, and biodegradability of scaffolds, and especially the use of exosome engineering as a biosignal molecule, which has become popular recently, bring another perspective on cartilage regeneration. The nanostructures of exosomes carry very important information between cells in terms of their anti-inflammatory activities and especially their effects on the proliferation and differentiation activities of stem cells. Especially modified or loaded exosome designs allow different approaches to be created in this field, both for therapeutics and diagnosis. This review offers a regenerative medicine perspective on ear reconstruction studies, addressing the advantages and disadvantages of experimental and clinical designs, including current innovations and artificial organ designs, such as stem cell-exosome strategies. The complexity of the production process, the characterization of biomaterials, the need for standardization of in vitro and in vivo protocols, ethical concerns, and high costs necessitate controlled and comparative analyses of these high-tech products/methods before they are transferred to clinical use.