Optimizing Alloplastic Microtia Reconstruction

Monday, September 30, 2024

9:30 AM – 9:36 AM EDT

Location: MBCC, Art Deco 228AB

Disclosure(s):

Gabriel Gomez, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Amit Kochhar, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Marta Kulich, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Beth A. Osterbauer, MPH:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Single stage microtia reconstruction surgery with a porous polyethylene (PPE) implant is a major endeavor with life changing implications for patients. In practice, variable results are seen and there is limited literature available to help predict patient outcomes. Patient and surgeon factors were studied in relation to aesthetic outcomes.

Methods: This retrospective cohort study included consecutive patients who underwent PPE microtia reconstruction between October 2020 and September 2023 by a single microtia team at an academic tertiary care children’s hospital. Data including demographics, height and weight, microtia grade, complications, and surgeon experience was collected. Reviewers (surgical residents) blinded to surgical details provided an aesthetic score for each postoperative photograph through a web-based survey.

Results: A total of 51 subjects undergoing primary microtia reconstruction were included: mean age was 9.5 years (range 4-18), 24 (47%) were female, 43 (84%) Hispanic, 33 (65%) were right-sided, 14 (27%) were grade 2, 36 (71%) were grade 3 microtia, and mean postoperative photo was taken 23 weeks following surgery. In multivariate analysis, younger patients and patients with normal body mass index (BMI) received higher mean aesthetic scores (p = 0.02, p = 0.07 respectively ). Mean aesthetic scores increased with surgical experience but the trend was not statistically significant (p = 0.3).Grade 2 microtia reconstructions had slightly higher aesthetic scores than Grade 3 (p = 0.5). Lower aesthetic scores were noted in the 7 (14%) patients requiring unplanned revisions for complications (p = 0.03).

Conclusions: This study analyzed patient and surgeon specific factors that impact microtia reconstruction results. Young age, normal BMI, and uncomplicated cases were strongly associated with improved aesthetic scores. Milder grade microtia and increasing surgeon experience may result in improved aesthetic outcomes. Otolaryngologist-head and neck surgeons can use this data to make the best possible decisions when evaluating their patients with microtia.

Presenting Author(s)

Gabriel Gomez, MD

Assistant Professor of Otolaryngology - Head & Neck Surgery
Children's Hospital Los Angeles
Los Angeles, CA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Senior Author(s)

Gabriel Gomez, MD

Assistant Professor of Otolaryngology - Head & Neck Surgery
Children's Hospital Los Angeles
Los Angeles, CA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

Amit Kochhar, MD

Facial Plastic and Reconstructive Surgery
Children's Hospital Los Angeles
Los Angeles, CA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Presenting Author(s)

Marta Kulich, MD

Resident PHysician
University of Southern California/LAC USC Med Ctr
Los Angeles, CA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

Marta Kulich, MD

Resident PHysician
University of Southern California/LAC USC Med Ctr
Los Angeles, CA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
Beth A. Osterbauer, MPH

Clinical Research Coordinator
Children's Hospital Los Angeles
Los Angeles, CA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
AG

Arom Gabriel, MD

Children's Hospital Los Angeles, United States

Disclosure information not submitted.