University of Southern California (USC) Medical Center, Keck School of Medicine, 401 S. Detroit St. #209, Los Angeles, CA 90036, USA.
Aesthetic Plast Surg. 2013 Apr;37(2):402-8. doi: 10.1007/s00266-012-0008-x. Epub 2013 Jan 26.
Microtia reconstruction remains one of the most challenging procedures encountered by the reconstructive surgeon. A national report on the current management of microtia has never been presented before. The purpose of this project was to survey members of the American Society of Plastic Surgeons (ASPS) to identify their preferences and practices and report their opinions regarding issues related to microtia reconstruction.
An anonymous web-based survey consisting of 19 questions was distributed to the members of the ASPS. Questions focused on the management of microtia. The study design was descriptive, using categorical data analysis.
Thirty-eight percent of all respondents perform microtia reconstruction; 91 % learned the autogenous cartilage-based reconstruction technique, while only 16 % were exposed to alloplastic reconstruction. Seventy percent of all respondents learned autogenous cartilage-based ear reconstruction exclusively. Fifty percent of respondents who perform microtia reconstruction reported a steep learning curve. In the pediatric patient population, 49 % of microtia surgeons prefer performing the surgery when the patient is between 7 and 10 years of age, while 40 % of microtia surgeons prefer the patient to be 4-6 years of age. Fifty-nine percent of all respondents believe that in 15 years tissue engineering will represent the gold standard of microtia reconstruction.
Staged microtia repair using autogenous cartilage remains the heavily favored method of microtia reconstruction among plastic surgeons. Moreover, there is a deficiency in training the newer surgical techniques, such as alloplastic and osseointegrated options. This study also highlights the continuing need to elucidate the optimal timing for microtia repair in the pediatric patient to mitigate the potential psychosocial morbidity well described in the literature.
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小耳畸形的重建仍然是整形外科医生面临的最具挑战性的手术之一。以前从未有过关于小耳畸形当前管理的全国性报告。本项目的目的是调查美国整形外科学会（ASPS）的成员，以确定他们的偏好和做法，并报告他们对小耳畸形重建相关问题的看法。
向 ASPS 成员分发了一份包含 19 个问题的匿名网络调查。问题集中在小耳畸形的管理上。研究设计为描述性的，使用分类数据分析。
38%的受访者进行小耳畸形重建；91%的人学习了自体软骨为基础的重建技术，而只有 16%的人接触过异体重建。所有受访者中有 70%的人专门学习了自体软骨为基础的耳朵重建。50%进行小耳畸形重建的受访者报告说，学习曲线很陡峭。在儿科患者群体中，49%的小耳畸形外科医生希望在患者 7 至 10 岁时进行手术，而 40%的小耳畸形外科医生希望患者年龄在 4-6 岁。59%的受访者认为，在 15 年内，组织工程将代表小耳畸形重建的黄金标准。
使用自体软骨的分期小耳畸形修复仍然是整形外科医生青睐的小耳畸形重建方法。此外，在培训新的手术技术（如异体和骨整合选项）方面存在不足。本研究还强调了继续阐明小儿患者小耳畸形修复的最佳时机的必要性，以减轻文献中充分描述的潜在心理社会发病率。
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