Guided Cartilage Regeneration Using Resorbable Template

Objective: The reconstruction of a defect involving complex cartilaginous structures such as the ear and nose is a difficult problem. Cartilage donor sites are limited, and the shaping of an ear or nose is dependent upon the surgeon's skills and experience. In this report, we propose to use resorbable plates that can be shaped to serve as a template for cartilage healing. Methods: A shell composed of polylactic/polyglycolic acid copolymer sheet was molded into different shapes. Autologous ribs harvested from 2 New Zealand rabbits were slightly crushed and bent without breaking, and placed within the pre-shaped shell. The constructs were implanted into subcutaneous pockets in the flanks of the rabbits. After 8 weeks, the implanted cartilage constructs were taken out of the shell and analyzed by the gross macroscopic appearance for preservation of the shape and by histological means for analysis of cartilage viability. Results: All of the explanted cartilage constructs retained the same pre-implanted shape and contour. Upon histological examination with hematoxylin/eosin staining, the constructs were composed of a continuous layer of viable chondrocytes. Conclusions: Construction of complex cartilaginous structures is an operator-dependent, technically difficult problem. We propose to use a resorbable template for guiding the shape and healing of the desired cartilaginous construct. Preoperative scanning and precise 3-dimensional shaping of the template could achieve further improvement in the desired cartilaginous support of the reconstructed part. In this report, we document that cartilage enclosed in a resorbable template retains its shape and viability. We believe that a prefabricated shell may help simplify and standardize outcomes of ear or nose reconstruction.