Patient Specific 3D-printed Surgical Guides for Autologous Auricular Reconstruction: The “Robert-Houdin Auricle Box” Concept

Autologous auricle reconstruction is widely accepted and used, with excellent results obtained from the hands of specialized surgeons. It is nevertheless an ever-evolving and advancing field, at the frontier of science and art, with a difficult surgical learning curve and complex postoperative management. Different strategies are used today, from fashioning the reconstruction from the patient's rib cartilage to bioengineering prosthetics to achieve specific cosmetic and functional outcomes. In this work, the authors present the first true surgical guide to harvest rib cartilage and sculpt a neo-auricle using the contralateral mirrored ear, without the need for additional specific surgical instruments or artistic knowledge. The name "Robert-Houdin Auricle Box" refers to the sawing magic illusion, popularized by the famous French magician Robert-Houdin, in which he was the first to appear to saw an assistant safely in half. The surgeon in this concept performs the same procedure with his scalpel, passing through the 3D printed box slots to safely saw and sculpt the cartilage block trap inside, following an appropriate virtual surgical planning (VSP) session.