Innovative tissue engineering strategies for auricular regeneration in microtia: Current advances and future perspectives

Microtia is a congenital auricular malformation that typically requires reconstructive surgery to restore both form and function. Autologous costal cartilage transplantation remains the clinical standard, yet its invasiveness and donor-site morbidity have driven growing interest in tissue-engineered alternatives. Modern cartilage tissue engineering integrates seed cells, biomaterial scaffolds, and bioactive factors, augmented by emerging technologies such as 3D printing, electrospinning, and dynamic bioreactors. This review summarizes recent progress in auricular reconstruction, with a focus on multilayer scaffold design, diverse cell sources, and advanced bioreactor systems. We emphasize the pivotal role of multi-omics technologies in elucidating the molecular mechanisms underlying chondrogenesis. However, despite substantial progress, clinical translation remains hindered by persistent challenges in replicating the complex architecture of the auricle and achieving long-term stability of engineered cartilage. Optimizing tissue engineering strategies and integrating regenerative medicine with surgical practice may help advance clinical outcomes in microtia treatment.