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Facial Plast Surg
DOI: 10.1055/a-2247-5109
Original Article

Reconstructive Techniques in Pediatric Congenital Microtia: A Systematic Review and Meta-analysis

Hugh Andrew Jinwook Kim   *
1   Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology – Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
,
Amirpouyan Namavarian   *
1   Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology – Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
,
Urooj Khan
1   Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology – Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
,
Ben B. Levy
1   Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology – Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
,
Hedyeh Ziai
1   Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology – Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
2   Beverly Hills Center for Facial Plastic Surgery, Beverly Hills, California
,
Ben Talei
2   Beverly Hills Center for Facial Plastic Surgery, Beverly Hills, California
,
Andres Gantous 
1   Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology – Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
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Abstract

Autografts and allografts are commonly used in microtia reconstruction. We aimed to systematically review and compare these reconstructive materials in pediatric congenital microtia reconstruction. A systematic review of the literature was performed. MEDLINE, Embase, PubMed, Web of Science, and CINAHL databases were searched for original studies on congenital microtia reconstruction in pediatric patients since database inception to 2021. Microtia grade was stratified as high or low. Meta-analysis of pooled proportions and continuous variables was performed using inverse variance weighting with a random effects model to compare between the autograft and allograft groups. Sixty-eight studies with a total of 5,546 patients used autografts (n = 5,382) or alloplastic implants (n = 164). Four other studies used prosthesis, cadaveric homografts, or tissue engineering. The allograft group was on average younger than the autograft group (8.4 vs. 11.1 years). There were no syndromic patients in the allograft group, compared to 43% in the autograft group. Patients treated with allografts had higher microtia grade than those treated with autograft (98 vs. 72%). Autografts were more commonly utilized by plastic surgeons and allografts by otolaryngologists (95 vs. 38%). No autografts and 41% of allografts were done concurrently with atresiaplasty or bone conduction implant. Satisfaction rates were similarly high (>90%) with similar complication rates (<10%). Microtia reconstruction using autografts and allografts had similar satisfaction and complication rates. Allografts were preferred for younger patients and concurrent hearing restoration. Further large-scale studies are required to evaluate the long-term efficacy of these reconstructive techniques.

Keywords

microtia - congenital - pediatric - reconstruction - craniofacial

Author Contributions

H.A.J.K., A.N., H.Z., and A.G. contributed to study design. H.A.J.K., A.N., and U.K. contributed to data acquisition. H.A.J.K. contributed to data analysis. H.A.J.K., A.N., B.B.L., H.Z., B.T., and A.G. contributed to data interpretation. H.A.J.K., A.N., and U.K. contributed to manuscript preparation. All authors contributed to manuscript revision. All authors approved the final version of the manuscript and agreed to be accountable for all aspects of the work.


* These authors contributed equally to this article.


Supplementary Material



Publication History

Accepted Manuscript online:
17 January 2024

Article published online:
23 February 2024

© 2024. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

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