PMID- 31624696
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231012
IS  - 2169-7574 (Print)
IS  - 2169-7574 (Electronic)
IS  - 2169-7574 (Linking)
VI  - 7
IP  - 6
DP  - 2019 Jun
TI  - Reconstruction of Congenital Microtia and Anotia: Analysis of Practitioner 
      Epidemiology and Postoperative Outcomes.
PG  - e2318
LID - 10.1097/GOX.0000000000002318 [doi]
LID - e2318
AB  - BACKGROUND: Microtia refers to a congenital malformation of the external ear that 
      is associated with a range of functional, psychosocial, aesthetic, and financial 
      burdens. The aim of this study was to analyze the epidemiology and postoperative 
      complication profile of microtia reconstruction. METHODS: A retrospective review 
      was conducted using data from the 2012-2017 the American College of Surgeons 
      National Quality Improvement Program Pediatric databases. Patients with a 
      diagnosis of microtia or anotia were identified using International 
      Classification of Diseases codes. Demographics and postoperative complications 
      were analyzed using Chi-square and t tests for categorical and continuous 
      variables, respectively. Multivariable regression was performed to control for 
      confounding variables. RESULTS: A total of 466 cases were analyzed, of which 290 
      (62.2%) were performed by plastic surgeons and 176 (37.8%) by otolaryngologists 
      (ear, nose, and throat physicians [ENT]). Autologous reconstruction was the 
      predominant approach [76.2% of cases (n = 355)] in this cohort. ENT physicians 
      operated on a significantly younger patient population (mean age 8.4 +/- 3.2 years 
      versus 10.0 +/- 3.2 years, P< 0.001) and had higher rates of concurrent 
      atresia/middle ear repair [21.0% (n = 37) versus 3.7% (n = 17)] compared with 
      plastic surgeons. The rate of all-cause complications was 5.9% (n = 17) in the 
      plastic surgery cohort and 4.0% (n = 7) in the ENT cohort (P= 0.372). 
      Multivariable regression did not reveal any statistically significant predictors 
      for all-cause complications. CONCLUSIONS: Reconstruction of the external ear for 
      patients with microtia/anotia is a safe procedure, with low rates of 
      postoperative complications, readmissions, and reoperations. Autologous 
      reconstruction remains the preferred modality for repair of the external ear and 
      simultaneous atresiaplasty/middle ear repair does not increase the risk of 
      complications.
CI  - Copyright (c) 2019 The Authors. Published by Wolters Kluwer Health, Inc. on behalf 
      of The American Society of Plastic Surgeons.
FAU - Cuccolo, Nicholas G
AU  - Cuccolo NG
AD  - Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical 
      Center, Harvard Medical School, Boston, Mass.
AD  - Department of Plastic and Oral Surgery, Boston Children's Hospital, Harvard 
      Medical School, Boston, Mass.
FAU - Zwierstra, Myrthe J
AU  - Zwierstra MJ
AD  - Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical 
      Center, Harvard Medical School, Boston, Mass.
FAU - Ibrahim, Ahmed M S
AU  - Ibrahim AMS
AD  - Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical 
      Center, Harvard Medical School, Boston, Mass.
FAU - Peymani, Abbas
AU  - Peymani A
AD  - Department of Plastic, Reconstructive and Hand Surgery, University of Amsterdam, 
      Amsterdam, Netherlands.
FAU - Afshar, Salim
AU  - Afshar S
AD  - Department of Plastic and Oral Surgery, Boston Children's Hospital, Harvard 
      Medical School, Boston, Mass.
FAU - Lin, Samuel J
AU  - Lin SJ
AD  - Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical 
      Center, Harvard Medical School, Boston, Mass.
LA  - eng
PT  - Journal Article
DEP - 20190619
PL  - United States
TA  - Plast Reconstr Surg Glob Open
JT  - Plastic and reconstructive surgery. Global open
JID - 101622231
PMC - PMC6635187
EDAT- 2019/10/19 06:00
MHDA- 2019/10/19 06:01
PMCR- 2019/06/19
CRDT- 2019/10/19 06:00
PHST- 2019/04/25 00:00 [received]
PHST- 2019/05/01 00:00 [accepted]
PHST- 2019/10/19 06:00 [entrez]
PHST- 2019/10/19 06:00 [pubmed]
PHST- 2019/10/19 06:01 [medline]
PHST- 2019/06/19 00:00 [pmc-release]
AID - 10.1097/GOX.0000000000002318 [doi]
PST - epublish
SO  - Plast Reconstr Surg Glob Open. 2019 Jun 19;7(6):e2318. doi: 
      10.1097/GOX.0000000000002318. eCollection 2019 Jun.