Gates-Tanzer Lauren, Mullen Barbara, Srikumar Jainaha, Mardini Samir, Sharaf Basel, Bite Uldis, Gibreel Waleed
Division of Plastic Surgery, Department of Surgery, Mayo Clinic, 200 1st ST, SW, Rochester, MN 55902, USA.
Division of Plastic Surgery, Department of Surgery, Mayo Clinic, 200 1st ST, SW, Rochester, MN 55902, USA.
J Plast Reconstr Aesthet Surg. 2025 Mar;102:58-65. doi: 10.1016/j.bjps.2025.01.019. Epub 2025 Jan 24.
Use of autogenous cartilage for ear reconstruction is the gold standard; however, its harvest is associated with morbidity and limited availability in children. This study systematically reviews literature on the safety and efficacy of ear reconstruction with cartilage allograft.
A systematic review per the PRISMA guidelines.
Patients with a history of acquired or congenital ear defects who underwent reconstruction with cartilage allografts.
The search yielded in 178 articles and 10 studies were included. All were retrospective case series or reports. At least 156 ears (150 patients) were reconstructed with cartilage allograft at a mean age of 12.2 years with a median follow-up duration of 48 months. If specified, most auricular defects were total defects (38/40) and congenital (56/61). Non-radiated cadaveric cartilage allograft was the most used material. Among the 156 ears, 72 ears had complications including total resorption (32/72), followed by partial resorption (29/72), extrusion (3/72), infection (3/72), and skin necrosis (2/72). Notably, resorption requiring surgical management was less frequent (18/61). Unplanned reoperation was performed in 23/156 cases. Improvements in function, that is ability to wear glasses and improvement in hearing, were mentioned by 2 patients.
Ear reconstruction with cartilage allograft provides the benefits of avoiding donor site morbidity and decreasing operative time. More rigorous and high quality studies are needed to reliably assess its safety as an alternative to autogenous or alloplastic material.
使用自体软骨进行耳再造是金标准；然而，其获取与发病率相关，且在儿童中可用性有限。本研究系统回顾了关于同种异体软骨耳再造安全性和有效性的文献。
按照PRISMA指南进行系统回顾。
有后天或先天性耳部缺陷病史且接受同种异体软骨再造的患者。
检索得到178篇文章，纳入10项研究。均为回顾性病例系列或报告。至少156只耳朵（150例患者）接受了同种异体软骨再造，平均年龄12.2岁，中位随访时间48个月。若有明确说明，大多数耳廓缺损为全耳缺损（38/40）且为先天性（56/61）。未照射的尸体同种异体软骨是最常用的材料。在这156只耳朵中，72只出现并发症，包括完全吸收（32/72），其次是部分吸收（29/72）、排斥（3/72）、感染（3/72）和皮肤坏死（2/72）。值得注意的是，需要手术处理的吸收情况较少见（18/61）。156例中有23例进行了非计划再次手术。2例患者提到功能有所改善，即能够佩戴眼镜和听力有所提高。
同种异体软骨耳再造具有避免供区发病和缩短手术时间的优点。需要更严格和高质量的研究来可靠评估其作为自体或异体材料替代品的安全性。
