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Application of cartilage tissue engineering in clinical practice In past decades, application of tissue-engineering technology on facial reconstructive surgery have markedly increased. However, cartilage regenerative medicine plays a relatively small role in current clinical practice (mainly in tracheal reconstruction [117] or articular joint resurfacing [118]) and have not yet been described for facial cartilage reconstruction. So far, only one study has reported proof-of-principle for human nasal reconstruction using tissue- engineered cartilage in five patients. [119] Assumedly, this opened the way to future clinical research of tissue-engineered facial cartilage and its utility in facial reconstructive surgery. For translation toward clinical application of cell-based cartilage repair, it is important to provide an one-step surgical procedure rather than multistage surgery. Such a procedure aims to generate a tissue-engineered construct intraoperatively, prohibiting the need for in-vitro culture expansion. One-step surgery would not only improve patient safety and cost- effectiveness but also reduce the risk of regulatory and ethical issues related to in-vitro culture expansion. CHAPTER 1 20