Long-term complications of microtia reconstruction: A systematic review

Published on Aug 17, 2021in Journal of Plastic Reconstructive and Aesthetic Surgery2.39
· DOI :10.1016/J.BJPS.2021.08.001
E.m. Ronde1
Estimated H-index: 1
(UvA: University of Amsterdam),
M. Esposito1
Estimated H-index: 1
(Sapienza University of Rome)
+ 3 AuthorsCorstiaan C. Breugem24
Estimated H-index: 24
(UvA: University of Amsterdam)
Sources
Abstract
Summary null Background null Microtia is a rare disorder characterized by malformation or even complete absence of the auricle. Reconstruction is often performed using autologous costal cartilage (ACC) or porous polyethylene implants (PPE). However, the long-term outcomes of both methods are unclear. null Objective null This systematic review aimed to analyze long-term complications and suggest minimal reporting criteria for future original data studies. null Methods null A systematic literature search was conducted in MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials from inception through October 14, 2020. Articles on auricular reconstruction in patients with microtia using ACC or PPE were included provided that the follow-up period was at least one year. This publication focused on long-term complications reported in patients with a postoperative follow-up period of at least one year. null Results null Twenty-nine publications reported on complications during long-term follow-up. Overall long-term complication rates were not reported. The incidence of individual complications during long-term follow-up was less than 10% after ACC reconstruction and less than 15% in PPE reconstruction. Framework resorption and wire exposure were reported even after an extended follow-up of more than five years after ACC reconstruction, while reports on the extended long-term results of PPE reconstruction are limited. Data synthesis was limited due to heterogeneity and poor study quality. null Conclusions null Future studies should report on long-term complications including framework exposure or extrusion, graft loss, framework resorption, wire exposure and scalp and auricular scar complications. We recommend a surgical follow-up of at least five years.
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