Charbel G Saad, Laurentia Fidella Averina Setia Santoso, Rola Mahdi, Soumiya Nadar, Thenuli Tamasha Jayamaha Hitihamilage, Nancy Emmanuel, Juan Pablo Menendez, Gregory Nicolas
The citation canon of autologous auricular reconstruction is built on the late 20th-century technique classics, whereas contemporary influence is increasingly driven by regenerative medicine and biofabrication. Future high-impact work will likely be defined by durable, shape-stable engineered constructs validated in clinically relevant models.
BACKGROUND: Autologous auricular reconstruction has evolved from cartilage-carving techniques that established modern microtia repair to an expanding regenerative and biofabrication literature. However, the field has not been mapped bibliometrically using an autologous-only lens that separates the clinical literature from emerging tissue-engineering hotspots.
METHODS: A Scopus search in January 2026 identified publications on autologous auricular reconstruction. Records were sorted by citation count, screened for eligibility, and the 100 most-cited studies were included. Data extracted included citations, citations per year, year, journal, country, and evidence category. Studies were classified into 4 domains: surgical technique, tissue engineering/basic science, complications/management, and outcomes/quality of life. VOSviewer was used for coauthorship and keyword co-occurrence mapping. Temporal shifts were assessed by comparing the older versus newer halves.
RESULTS: The 100 most-cited studies (1971-2023) accrued a mean of 82.97 citations (range, 27-510) with a median of 3.46 citations per year. Most studies were clinical (71%), followed by preclinical (19%) and evidence synthesis (10%). Surgical technique predominated overall (53%), but decreased from 66% in the older half to 40% in the newer half, whereas tissue engineering increased from 16% to 28%. The most-cited article was the description by Nagata of a 2-stage, 3-dimensional costal cartilage framework (1993, Plastic and Reconstructive Surgery). Keyword clustering revealed a temporally newer regenerative cluster centered on chondrocytes, tissue engineering, and biomechanics.
CONCLUSIONS: The citation canon of autologous auricular reconstruction is built on the late 20th-century technique classics, whereas contemporary influence is increasingly driven by regenerative medicine and biofabrication. Future high-impact work will likely be defined by durable, shape-stable engineered constructs validated in clinically relevant models.