(0520) Microtia Reconstruction Practices Among Otolaryngologists in the United States

Introduction: Microtia repair is a technically complex surgery with significant variability in practice. Over the past 100 years, many methods have been used to achieve outcomes satisfactory to the patient and the surgeon. Though almost half of microtia repair is performed by Otolaryngology-trained surgeons, their characteristics, referral patterns, and preferences are poorly understood.

Methods: A 22-question anonymous digital survey of practice patterns and surgical methods was distributed to the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) and the American Society of Pediatric Otolaryngology (ASPO). Responses were collected and analyzed using descriptive statistics and linear regression models.

Results: The survey was distributed to 1,730 members. Received were 83 survey responses that were adequate for analysis, yielding a 4.8% response rate. Of them, 43 respondents (51.8%) were members of AAFPRS, 39 (47%) were members of ASPO, and 1 (1.2%) reported dual membership. Respondents had multiple practice models, were at different stages in their practice experience, and were well-distributed geographically. Additionally, 40 (48.2%) reported they do not do microtia repair and about half (52.5%) refer to a FPRS-trained colleague. Among microtia surgeons, most (n = 30, 69.8%) received fellowship training. Autologous reconstruction was the most popular method for both training and practice; however, most perform multiple methods (n = 33, 76.7%). Training in autologous rib reconstruction was positively correlated with experience >20 years in practice. Those who have a combined autologous/alloplastic reconstructive practice were more often trained via pediatric otolaryngology fellowship. Surgical site infection was the most frequent complication and was seen more often by those trained via residency alone (OR: 12.8, p < 0.05).

Conclusions: Otolaryngology-trained microtia surgeons come from a variety of academic backgrounds and progress to varied practices. They tend to be trained and practice in both alloplastic and autologous repair methods, though autologous methods remain the most common.