Abukhder Munir, Tarassoli Sam, Hassan Ridwanul, Onions Elizabeth, Nasri Elmi Salmane, Whelan Rhys
Oral and Maxillofacial Surgery, Northwick Park Hospital, London, GBR.
Plastic Surgery, Morriston Hospital, Swansea, GBR.
Cureus. 2024 Mar 17;16(3):e56345. doi: 10.7759/cureus.56345. eCollection 2024 Mar.
Auricular reconstruction remains a challenging procedure, requiring a high degree of manual dexterity and attention to detail in order to reconstruct the complex three-dimensional geometry of the ear successfully. Most techniques will rely on autologous cartilage for auricular framework fabrication, carrying a risk of donor and recipient site morbidity. The aim of this report is to investigate the complications and aesthetic outcomes associated with autologous cartilage harvest in auricular reconstruction. A systematic review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) and reported in accordance with the Preferred Reporting for Items for Systematic Reviews and Meta-Analyses. Comprehensive electronic search strategies for four databases were developed. Studies were screened according to the inclusion and exclusion criteria by two independent reviewers. The literature search identified 7171 articles. Filtering for relevance and duplication reduced the number of articles to 52. A total of 12,215 patients underwent auricular reconstruction utilising autologous cartilage. Indications included 11,696 patients due to microtia, 334 patients due to burns or trauma, 70 patients due to constricted ears, and 115 patients due to prominent ears. The most commonly reported donor site complications included chest wall deformities (n = 159). The most commonly reported recipient site complications included hypertrophic or keloid scars (n = 279), haematoma (n = 155), tissue expander exposure (n = 111), cartilage or framework exposure (n = 122), and cartilage framework deformation or resorption (n = 50). Although a challenging procedure, auricular reconstruction utilising autologous cartilage is possible. Exceptional aesthetic results can be achieved when performed by a skilled surgeon on appropriately selected individuals. However, the potential risks and complications associated with the procedure should be discussed with the patient and family beforehand.
耳廓再造仍然是一项具有挑战性的手术，需要高度的手部灵活性和对细节的关注，以便成功重建耳朵复杂的三维几何形状。大多数技术依赖自体软骨制作耳廓支架，存在供区和受区发病的风险。本报告的目的是研究耳廓再造中自体软骨采集相关的并发症和美学效果。一项系统评价方案已在国际系统评价前瞻性注册库（PROSPERO）注册，并按照系统评价和Meta分析的首选报告项目进行报告。制定了针对四个数据库的全面电子检索策略。由两名独立评审员根据纳入和排除标准对研究进行筛选。文献检索共识别出7171篇文章。经过相关性和重复性筛选，文章数量减少至52篇。共有12215例患者接受了自体软骨耳廓再造。适应证包括11696例小耳畸形患者、334例烧伤或创伤患者、70例耳部狭窄患者和115例招风耳患者。最常报告的供区并发症包括胸壁畸形（n = 159）。最常报告的受区并发症包括增生性或瘢痕疙瘩性瘢痕（n = 279）、血肿（n = 155）、组织扩张器外露（n = 111）、软骨或支架外露（n = 122）以及软骨支架变形或吸收（n = 50）。尽管是一项具有挑战性的手术，但利用自体软骨进行耳廓再造是可行的。由熟练的外科医生对适当选择的个体进行手术时，可以获得出色的美学效果。然而，术前应与患者及其家属讨论该手术潜在的风险和并发症。
