Core Viewpoint - The article discusses a breakthrough in reconstructive surgery for ear deformities, utilizing bacteria as a "biological 3D printer" to create customizable artificial ear scaffolds, potentially transforming clinical practices in auricular reconstruction [2][4]. Group 1: Challenges in Traditional Methods - Traditional ear reconstruction methods involve harvesting rib cartilage, which presents three main challenges: insufficient rib cartilage in children requiring multiple surgeries, the complexity of sculpting and stitching that relies heavily on the surgeon's skill, and the risk of postoperative complications such as infections and scaffold exposure [4][5]. - Existing artificial materials used as cartilage substitutes also face issues, including manual shaping and stitching, along with the risk of rejection [4]. Group 2: Innovative Approach - The research team focused on the bacterium Komagataeibacter xylinus, which can synthesize bacterial cellulose known for its high purity, nanoscale network structure, excellent biocompatibility, and functionalization properties [4][5]. - The bacteria exhibit an "oxygen navigation" feature, allowing them to gather in oxygen-rich areas and secrete nanofibers, which are utilized to create the ear scaffold [5]. Group 3: Key Innovations in Scaffold Production - The team designed a high-oxygen-permeable silicone mold to achieve three critical controls: precise molds created from 3D-printed ear models, dynamic oxygen supply to guide bacteria evenly throughout the scaffold, and nanometer-level precision in the cellulose fibers produced [5][7]. - The cellulose fibers have a diameter of 20-100 nanometers and form a cartilage-like network structure with mechanical strength comparable to real ear cartilage, with an elastic modulus ranging from 3.89 to 9.56 MPa [5][8]. Group 4: Performance and Clinical Implications - After 21 days of bacterial "biomanufacturing" and purification, the artificial ear scaffolds demonstrated remarkable characteristics: precise replication of ear structures, high tensile strength with no deformation after 50 days of immersion, long-term stability in the body, and extremely low endotoxin levels [8][9]. - The scaffolds show over 95% survival rates for cartilage and skin cells, allowing for rapid integration with surrounding tissues, indicating significant clinical application potential for personalized ear reconstruction [9]. Group 5: Broader Impact - This research marks the first application of microbial manufacturing technology in organ reconstruction, offering hope for patients with ear deformities and paving the way for future developments in complex tissue engineering, potentially extending to heart valves and vascular networks [9].