Kulich Marta, Patel Vijay A, Rezvan Panteha Hayati, Osterbauer Beth, Kochhar Amit, Gomez Gabriel
Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, Children's Hospital of Los Angeles, Los Angeles, California, USA.
Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA.
Facial Plast Surg Aesthet Med. 2023 Jul-Aug;25(4):290-295. doi: 10.1089/fpsam.2022.0406. Epub 2023 Apr 20.
Auricular reconstruction techniques most frequently utilize either autologous costal cartilage or alloplastic porous polyethylene (PPE) implant. To compare the aesthetic outcomes, number of surgeries, and complications in children who underwent microtia reconstruction with either rib or PPE implant by blinded photograph review. This retrospective cohort study included consecutive pediatric patients who underwent auricular reconstruction with either autologous cartilage or PPE between November 2017 and February 2022. Blinded observers rated each postoperative ear through a web-based survey. Data on patient characteristics, operative time, length of admission, and complications were collected, bivariate analyses were performed using chi-square or Fisher's exact tests for categorical variables and Wilcoxon rank-sum test for continuous variables. Forty-four ears were included, 28 of which (63.6%) were reconstructed with cartilage. Median patient age was 8 years (range 4-18 years) and 29 (65.9%) were male. The cartilage group had more surgeries (median 2.5 vs. 1.0, < 0.001), and total operating time across all surgeries did not differ significantly. The two groups in our study had similar rates of complications and aesthetic scores, and aesthetic scores were worse for ears with wound complications requiring unplanned revisions.
耳廓重建技术最常使用自体肋软骨或异体多孔聚乙烯（PPE）植入物。通过盲法照片回顾比较接受肋软骨或PPE植入物进行小耳畸形重建的儿童的美学效果、手术次数和并发症。这项回顾性队列研究纳入了2017年11月至2022年2月期间连续接受自体软骨或PPE耳廓重建的儿科患者。盲法观察者通过基于网络的调查对每只术后耳朵进行评分。收集患者特征、手术时间、住院时间和并发症的数据，对分类变量使用卡方检验或Fisher精确检验，对连续变量使用Wilcoxon秩和检验进行双变量分析。共纳入44只耳朵，其中28只（63.6%）采用软骨重建。患者中位年龄为8岁（范围4 - 18岁），男性29例（65.9%）。软骨组手术次数更多（中位数2.5次对1.0次，P < 0.001），所有手术的总手术时间无显著差异。我们研究中的两组并发症发生率和美学评分相似，对于因伤口并发症需要进行计划外修复的耳朵，美学评分更差。
