Promising Extracellular Matrix (ECM) Enzymes: Collagenase II and Chondroitinase as Non-surgical Interventions in Correcting Ear Deformities

This hypothesis addresses the challenges of non-surgical treatment for congenital auricular deformities by exploring the feasibility of using digestive enzymes, such as collagenase and chondroitinase (ChSase), for cartilage remodeling. Congenital auricular deformity is a common external malformation, and some cases require clinical intervention for correction. Although surgical treatment is well-established, it carries associated risks, making early non-surgical intervention particularly important. Current non-surgical treatments rely heavily on the neonatal cartilage's pliability but are limited by a narrow window of opportunity dictated by hormonal influences after birth. To overcome this barrier, we propose a hypothesis that local injection of digestive enzymes can modulate the mechanical properties of the cartilage matrix, thereby promoting cartilage reshaping. By leveraging enzymes like collagenase and ChSase, selective degradation of cartilage matrix elements is achieved, inducing plasticity while preserving cellular viability. This strategy has the potential to extend the window of opportunity for cartilage reshaping and provides a novel theoretical basis for early non-surgical correction of congenital auricular deformities. We conclude that although this hypothesis may appear overly simplistic, it is feasible and merits further investigation.