Autologous cartilage microtia reconstruction: Complications and risk factors

Fu, Yaoyao; Li, Chenlong; Zhang, Junli; Zhang, Tianyu

doi:10.1016/j.ijporl.2018.09.035

Cited by 41 publications

(29 citation statements)

References 24 publications

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“…Post-reconstructive surgery infection is associated with poor wound healing and graft failure [ 30 – 33 ]. Conversely, Fu et al [ 34 ] showed delayed wound healing as the most common complication found in patients with microtia after reconstructive surgery [ 34 ]. It is assumed that the factor affecting these results is environmental hygiene.…”

Section: Discussionmentioning

confidence: 99%

Satisfaction and health-related quality of life of patients with microtia following reconstructive surgery using the Nagata technique

et al. 2021

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Objective This study aimed to investigate the functional outcomes, satisfaction, and quality of life of patients with microtia following reconstructive surgery. Methods This cross-sectional study was conducted using retrospective data of patients with microtia following reconstructive surgery using the Nagata technique. Data were obtained from the medical records of patients who underwent reconstructive surgery at the Division of Facial Plastic and Reconstructive Surgery, Department of Otorhinolaryngology, Head and Neck Surgery, Dr. Cipto Mangunkusumo Hospital between 2014 and 2018. All eligible patients were referred to participate in this study between November 2018 and March 2019. The hearing function was assessed by a professional audiologist after surgery. Patient satisfaction was evaluated by interview using a previously developed questionnaire, while quality of life was assessed using the EuroQol-5D-Young questionnaire. Results Thirty-one eligible subjects were included in the study. Pain and discomfort were the most commonly reported factors related to the quality of life following surgery. Approximately 67.7% of the patients were satisfied; 19.4% were very satisfied, and 12.9% reported acceptance of their surgical outcomes. The most common complication was infection (n = 8). Most patients did not experience any problems in their lives after microtia surgery. Conclusions The highest rate of satisfactory outcomes was observed for the lobule subunit, which was assumed to be associated with the use of the Z-plasty technique. The most common complication was infection, as environmental hygiene was the most important factor. Thus, further concern for maintaining good hygiene is necessary to improve the quality of reconstructive surgery. The level of satisfaction with microtia reconstructive surgery was adequate. Most patients had a good health-related quality of life without experiencing any problems.

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Section: Discussionmentioning

confidence: 99%

Satisfaction and health-related quality of life of patients with microtia following reconstructive surgery using the Nagata technique

et al. 2021

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“…There is currently no consensus concerning the pathogenesis and etiology of microtia. Total auricular reconstruction remains the primary treatment for microtia (5), and is a great challenge for plastic surgeons globally. The skin envelope and the three-dimensional framework are two eternal themes of auricular reconstruction (6).…”

Section: Introductionmentioning

confidence: 99%

Clinical efficacy of modified total auricular reconstruction technique by using reformative inflation method and remnant ear without skin grafting

Liu¹,

Wei²,

Zhu³

et al. 2021

Ann Transl Med

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Background: As one of the most widely used methods to treat microtia, the auricular reconstruction proposed by Zhuang may have several drawbacks. This study aimed to introduce a modified Zhuang's ear reconstruction technique by using a reformative inflation method and remnant ear to shorten therapy time and avoid skin grafting in a two-stage operation for patients with microtia.Methods: A total of 124 patients with microtia were enrolled consecutively from 2014 to 2018. Among them, 66 patients underwent a modified Zhuang's method, and the remaining patients underwent Zhuang's method. The clinical and perioperative characteristics of patients, as well as complications and esthetic outcomes were analyzed.

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“…The most accepted protocol among surgeons worldwide is that the Nagata technique and its modifications typically used the ipsilateral rib cartilage to form the framework in the first-stage surgery ( Bly et al, 2016 ). Irrespective of the kind of operation, the postoperational complications were inevitable ( Fu et al, 2019 ). Skin necrosis is one of the most common complications, which mainly occurred after the first-stage modification.…”

Section: Introductionmentioning

confidence: 99%

Shape Optimization of Costal Cartilage Framework Fabrication Based on Finite Element Analysis for Reducing Incidence of Auricular Reconstruction Complications

Zhong

Chen

Zhao

et al. 2021

Front. Bioeng. Biotechnol.

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Skin necrosis is the most common complication in total auricular reconstruction, which is mainly induced by vascular compromise and local stress concentration of the overlying skin. Previous studies generally emphasized the increase in the skin flap blood supply, while few reports considered the mechanical factors. However, skin injury is inevitable due to uneasily altered loads generated by the intraoperative continuous negative suction and uneven cartilage framework structure. Herein, this study aims to attain the stable design protocol of the ear cartilage framework to decrease mechanical damage and the incidence of skin necrosis. Finite element analysis was initially utilized to simulate the reconstructive process while the shape optimization technique was then adopted to optimize the three-pretested shape of the hollows inside the scapha and fossa triangularis under negative suction pressure. Finally, the optimal results would be output automatically to meet clinical requirement. Guided by the results of FE-based shape optimization, the optimum framework with the smallest holes inside the scapha and fossa triangularis was derived. Subsequent finite element analysis results also demonstrated the displacement and stress of the post-optimized model were declined 64.9 and 40.1%, respectively. The following clinical study was performed to reveal that this new design reported lower rates of skin necrosis decrease to 5.08%, as well as the cartilage disclosure decreased sharply from 14.2 to 3.39% compared to the conventional method. Both the biomechanical analysis and the clinical study confirmed that the novel design framework could effectively reduce the rates of skin necrosis, which shows important clinical significance for protecting against skin necrosis.

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Autologous cartilage microtia reconstruction: Complications and risk factors

Cited by 41 publications

References 24 publications

Satisfaction and health-related quality of life of patients with microtia following reconstructive surgery using the Nagata technique

Satisfaction and health-related quality of life of patients with microtia following reconstructive surgery using the Nagata technique

Clinical efficacy of modified total auricular reconstruction technique by using reformative inflation method and remnant ear without skin grafting

Shape Optimization of Costal Cartilage Framework Fabrication Based on Finite Element Analysis for Reducing Incidence of Auricular Reconstruction Complications

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