“It is not that common, but nevertheless more frequent than assumed,” said Nicole Rotter, executive senior physician in the Department of Otorhinolaryngology, Head and Neck Surgery at Ulm University Hospital, referring to damaged or torn off auricles, the reconstruction of which is difficult and complex. Current methods involve the reconstruction of auricles from rib cartilage, which requires several steps, including the removal of three to four ribs during several surgical interventions of between four and five hours.
Now, an international group of researchers, including Nicole Rotter and her team at the University Hospital in Ulm, is working on alternative methods. The objective of the group is to develop auricle transplants from autologous cells, a process that experts refer to as tissue engineering. The medical specialist from Ulm received a research prize of the Ingrid-zu-Solms Foundation earlier this year for her previous achievements in this field. The prize, which comes with a purse of 10,000 euro, has been awarded exclusively to women every other year since 1994 for excellent work in basic research.
The Department of Otorhinolaryngology, Head and Neck Surgery at Ulm University Hospital was recently granted 330,000 euro from the German Federal Ministry of Research and Education for a subproject that is part of a large EU project. This European-wide project involves researchers from the Universities of Gothenburg (Sweden) and Rotterdam (Netherlands) as well as from the ETH in Zurich (Switzerland) and renowned companies from Germany and the Netherlands.
The major goal of the three-year research project is to develop new strategies for the regeneration of auricular cartilage involving innovative biomaterials. “All project partners have long-standing experience in this field and have carried out promising preliminary work,” said the researcher from Ulm going on to add that “the Swedish colleagues, for example, deal with the production of cellulose using bacterial systems, whereas the problem of making reconstructed cartilage tissue mechanically stable is one that all the groups are trying to solve.” Nicole Rotter obtained her doctoral degree from the University of Munich (LMU) and has ever since been focussed on tissue engineering, both in Germany and during several research stays in the USA. Rotter believes that the reason why the reconstruction of parts in the neck and head area has not yet entered clinical routine is that far less funding has been provided for this type of research. Much more funding is being invested in research focussing on the reconstruction of joints, as great demand is expected. However, Rotter is certain that a similar demand can be envisaged for the head and neck area, including ears, especially as far as the reconstruction of auricles is concerned. Rotter believes that this great demand arises from innate auricle damage, tumours, car and bicycle accidents, as well as injuries caused by horse bites and driving cabriolets.
Rotter explains that the reconstruction of the auricular cartilage scaffold requires a large amount of tissue and also highlights that the reconstruction of auricular skin is anything but easy. This is why only a few hospitals are specialised on the reconstruction of complete auricles. Rotter's team of eight researchers frequently reconstructs parts of auricles and Rotter is convinced that auricle reconstruction will also be possible with autologous tissue. The EU project will be funded for three years. "It would be fantastic if we were able to reach our goal when the funding comes to an end in about three years' time," said Rotter expressing cautious optimism.
Nicole Rotter explains that their alternative method has clear advantages: On the one hand, the patients are exposed to less strain. On the other hand, the implants made from autologous tissue are far better accepted by the immune system than xenogenous materials. "Dr. Nicole Rotter's research makes an important contribution to one of the key technologies used in regenerative medicine," said the Solms Foundation explaining their reason to award the scientist from Ulm with the Ingrid-zu-Solms research prize.