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Computer-Aided Design and 3D Printing to Produce a Costal Cartilage Model for Simulation of Auricular Reconstruction

M icrotia, or underdevelopment of the auricle, affects approximately 0.03% of live births. Carving an auricular cartilage framework from autogenous cartilage—the most common technique for auricular reconstruction—is one of the most challenging skills for the reconstructive surgeon to learn. Given the potential morbidity associated with technical errors in framework carving, opportunities for acquisition of this skill are limited. It is critical for surgeons to be able to practice their carving skills. This presents an opportunity for surgical simulation. Materials previously used for simulation of auricular framework carving include carrots, potatoes, porcine/bovine/human cadaveric costal cartilage, and dental impression material. These materials poorly represent the geometry, texture, and size of the harvested costal cartilage presented to the reconstructive surgeon. There is a commercially available model (Medicon, Tuttlingen, Germany) that is based on adult rib and is costly. To better represent pediatric rib geometry and texture, techniques were developed to produce negative molds from harvested pediatric rib cartilage. While these methods are an improvement on the simulation of shape and size, questions remained on the similarity of the material to costal cartilage. In this report, we aim to use computer-aided design and 3dimensional (3D) printing to create a representative pediatric costal cartilage model for simulation of auricular framework reconstruction. Furthermore, with computed tomography scan data, the potential for patient-specific simulation is introduced, allowing for surgical planning.