Jovic Thomas H, Gibson John A G, Griffiths Rowena, Dobbs Thomas D, Akbari Ashley, Wilson-Jones Nicholas, Costello Rhodri, Evans Peter, Cooper Mark, Key Steve, Lyons Ronan, Whitaker Iain S
The Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, United Kingdom.
Reconstructive Surgery and Regenerative Medicine Research Group (ReconRegen), Swansea University Medical School, Institute of Life Sciences, Swansea, United Kingdom.
Front Pediatr. 2021 Mar 26;9:630036. doi: 10.3389/fped.2021.630036. eCollection 2021.
Previous studies of microtia epidemiology globally have demonstrated significant geographical and ethnic variation, cited broadly as affecting 3-5 in 10,000 live births. The aim of this study was to determine the incidence of microtia in a largely homogeneous ethnic population in the United Kingdom (Wales) and to identify factors, such as distance and socioeconomic status, which may influence the access to surgical intervention. A retrospective cohort study was conducted using data linkage to identify patients born between 2000 and 2018 with a diagnosis of microtia. Microtia incidence was calculated using annual and geographic birth rates. Surgical operation codes were used to classify patients into those that had no surgery, autologous reconstruction or prosthetic reconstruction. Sociodemographic attributes were compared using descriptive statistics to determine differences in access to each type of surgical intervention. A total of 101 patients were identified, 64.4% were male and the median age was 12 (8-16). The mean annual incidence was 2.13 microtia cases per 10,000 births over the 19-year study period. Both temporal and geographic variation was noted. The majority of patients undergoing surgery opted for autologous reconstruction (72.9%) at a median age of 9 (7-10) compared to 7 (5-8) for prosthetic reconstruction. Autologous reconstruction had a higher median number of surgeries (2, 1-3) than prosthetic (1.5, 1-2) and a higher median socioeconomic status of 3 (2-4) compared to 2 (1-4) for the prosthetic cohort. There were no statistically significant differences in the distance traveled for surgery. This study highlights a role for data linkage in epidemiological analyses and provides a revised incidence of microtia in Wales. Although the majority of patients opted for autologous reconstruction, demographic disparities in socioeconomic status warrant further investigation, emphasizing the importance of striving for equity in accessibility to surgical intervention.
此前全球范围内关于小耳症流行病学的研究表明，其存在显著的地理和种族差异，普遍认为每10000例活产儿中有3至5例受影响。本研究的目的是确定英国（威尔士）一个基本同质的种族群体中小耳症的发病率，并确定可能影响手术干预可及性的因素，如距离和社会经济地位。我们进行了一项回顾性队列研究，通过数据关联来识别2000年至2018年间出生且诊断为小耳症的患者。小耳症发病率通过年度和地理出生率来计算。手术操作编码用于将患者分为未接受手术、自体重建或假体重建的患者。使用描述性统计比较社会人口学属性，以确定每种手术干预可及性的差异。共识别出101例患者，其中64.4%为男性，中位年龄为12岁（8至16岁）。在19年的研究期间，平均年发病率为每10000例出生中有2.13例小耳症病例。观察到时间和地理上的差异。大多数接受手术的患者选择自体重建（72.9%），中位年龄为9岁（7至10岁），而假体重建的中位年龄为7岁（5至8岁）。自体重建的手术中位数（2，1至3）高于假体重建（1.5，1至2）；与假体组的社会经济地位中位数2（1至4）相比，自体重建组的社会经济地位中位数为3（2至4）。手术行程距离没有统计学上的显著差异。本研究突出了数据关联在流行病学分析中的作用，并提供了威尔士小耳症发病率的修订数据。尽管大多数患者选择自体重建，但社会经济地位方面的人口统计学差异值得进一步研究，这强调了在手术干预可及性方面追求公平的重要性。
