Auricular reconstruction using Medpor combined with different hearing rehabilitation approaches for microtia

Jiang, Chenyan; Zhao, Chen; Chen, Bin; Lu, Lixin; Sun, Yuxin; Yan, Xirui; Yi, Bin; Wu, Hao; Shi, Runjie

doi:10.1080/00016489.2021.1900601

Cited by 7 publications

(6 citation statements)

References 18 publications

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“…An overview of the search process can be found in Figure 1. Descriptive features of articles about atresia surgery can be found in Supplemental Content 2, http://links.lww.com/MAO/B684 (9,10,18–52), and descriptive features of articles about implantable devices can be found in Supplemental Content 3, http://links.lww.com/MAO/B685 (8,10,22,43,47,48,53–99). All articles selected for inclusion were at least level 4 based on Oxford Level of Evidence.…”

Section: Resultsmentioning

confidence: 99%

Comparison of Outcomes of Surgery Versus Implantable Device for the Treatment of Hearing Loss Associated With Congenital Aural Atresia: A Systematic Review and Meta-Analysis

et al. 2023

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Objective To compare audiometric outcomes, complications, and revisions required for implantable bone-conduction devices (BCDs) versus atresia surgery for the treatment of hearing loss associated with congenital aural atresia. Databases Reviewed PubMed, Scopus, CINAHL. Methods Databases were searched for English articles from inception to July 1, 2022, for studies reporting audiometric outcomes or complications for either BCDs or atresia surgery for the treatment of congenital aural atresia. Main outcome measures included pure-tone audiometry, air-bone gap, speech reception threshold, associated complications, and rates of revision for each treatment option. Results We identified 973 abstracts, of which 89 were selected for data extraction and analysis. A total of 2,611 patients were included, 1,901 in the atresia surgery group and 710 in the BCDs group. A meta-analysis of single means was conducted for age and audiometric outcomes, and a meta-analysis of proportions was conducted for complications and revisions. The average short-term improvement in pure-tone audiometry for the BCDs group was 34.4 ± 1.6 dB compared with 22.4 ± 1.5 dB for the atresia surgery group, representing a significant difference (12.0 dB; 95% confidence interval, 11.9–12.2; p < 0.0001). A smaller proportion of complications were reported in the devices group (16.9%) compared with the atresia surgery group (45.7%). In addition, a smaller proportion of cases in the devices group required some degree of revision (17.8%) compared with the atresia surgery group (23.0%). Conclusions This study demonstrates that implantable BCDs have significantly better audiometric outcomes as well as a lower rate of complications and revisions required compared with atresia surgery.

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Section: Resultsmentioning

confidence: 99%

Comparison of Outcomes of Surgery Versus Implantable Device for the Treatment of Hearing Loss Associated With Congenital Aural Atresia: A Systematic Review and Meta-Analysis

et al. 2023

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“…The articles included in this study are of high quality, the sample size is large, the analysis is scientific and rigorous, and the conclusions drawn from this study are of high credibility. However, this meta-analysis also has some limitations: (1) The studies included in single-arm meta-analysis lacked control groups and showed great heterogeneity; (2) Among the 14 studies included in this meta-analysis, 10 were from China, 2 from Korea, 1 from Colombia, and 1 from the United Kingdom. The majority of the populations included in this meta-analysis were from the eastern population.…”

Section: Discussionmentioning

confidence: 99%

“…Congenital microtia is one of the most common organ malformations in plastic surgery. 1 Its main treatment is auricle reconstruction. The reconstructed ear needs to have good shape, realistic detail, proper projection, and symmetrical position to be considered a successful auricle reconstruction.…”

Section: Introductionmentioning

confidence: 99%

Comparison of auricle reconstruction with expanded flaps and auricle reconstruction with non-expanded flaps in patients with microtia: A meta-analysis

et al. 2021

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Objective We conducted this meta-analysis to compare the efficacy of these two surgical methods by comparing the incidence of major evaluation indicators. Methods The databases such as PubMed, Embase, the Cochrane Library, China National Knowledge Infrastructure, Wanfang, and VIP information databases were searched. Results The satisfaction rate of patients with auricle reconstruction using expanded flaps was 86.5%, and the satisfaction rate of patients with auricle reconstruction using non-expanded flaps was 87.9%. The incidence of postoperative hematoma was 2.5% in patients with auricle reconstruction using expanded flaps and 18.9% in patients with auricle reconstruction using non-expanded flaps. The incidence of postoperative skin necrosis was 1.2% in patients with auricle reconstruction using expanded flaps and 4.1% in patients with auricle reconstruction using non-expanded flaps. The incidence of postoperative incision infection was 2.4% in patients with auricle reconstruction using expanded flaps and 0.9% in patients with auricle reconstruction using non-expanded flaps. The incidence of cartilage framework exposure was 2.2% in patients with auricle reconstruction using expanded flaps and 1.9% in patients with auricle reconstruction using non-expanded flaps. The incidence of postoperative scar hyperplasia was 3.8% in patients with auricle reconstruction using expanded flaps and 3% in patients with auricle reconstruction using non-expanded flaps. The publication bias of included literature was evaluated by Egger test. There was no publication bias in this Meta-analysis ( P > .05). Conclusion The auricle reconstruction using non-expanded flaps is dominant in four of the six evaluation indexes. Therefore, we believe that the auricle reconstruction using non-expanded flaps has better therapeutic effect in patients with microtia. Due to the limitations of this meta-analysis, the conclusions of this meta-analysis still need to be further verified.

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“…With the addition of two studies which were found through screening the reference lists of included studies, 72 studies were included in the systematic review (Figure 1, Supplementary Table S1). 4,13, There were 56 included studies that used autologous cartilage, 4,13,23-25,27,31-36,38,41-43,45-50,53-63,65-68,71-83,85,86,88,90-92 six studies that used alloplastic implants, 28,37,40,44,70,87 and six studies featuring both techniques, with a total of 5546 patients included. 26,29,30,39,52,64 The remaining studies used prostheses, 51,69 tissue engineering, 89 and an irradiated cadaver homograft.…”

Section: Overview Of Included Studiesmentioning

confidence: 99%

“…Several studies in our review devised and explained their own scoring systems, which in some instances even included the use of multiple independent evaluators. 29,40,47,53,66,88 However, none of these scoring systems were This article is protected by copyright. All rights reserved.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

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

Kim,

Namavarian,

Khan

et al. 2024

Facial Plast Surg

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Objective: Autografts and allografts are commonly used in microtia reconstruction. We aimed to systematically review and compare these reconstructive materials in pediatric congenital microtia reconstruction. Data Sources: 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. Methods: 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. Results: Sixty-eight studies with a total of 5546 patients used autografts (n=5382) 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%). Conclusion: 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.

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Auricular reconstruction using Medpor combined with different hearing rehabilitation approaches for microtia

Cited by 7 publications

References 18 publications

Comparison of Outcomes of Surgery Versus Implantable Device for the Treatment of Hearing Loss Associated With Congenital Aural Atresia: A Systematic Review and Meta-Analysis

Comparison of Outcomes of Surgery Versus Implantable Device for the Treatment of Hearing Loss Associated With Congenital Aural Atresia: A Systematic Review and Meta-Analysis

Comparison of auricle reconstruction with expanded flaps and auricle reconstruction with non-expanded flaps in patients with microtia: A meta-analysis

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

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