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Synthetic vs natural grafting material for microtia reconstruction?

Article-Synthetic vs natural grafting material for microtia reconstruction?

Congenital deformities of the ear require choosing the right technique to effectively balance both function and aesthetics. When approaching microtia reconstruction, one of the questions researchers at The University of Texas Southwestern Medical Center, Dallas, recently sought to answer is whether better overall results can be achieved with synthetic versus natural reconstructive materials. Their study results were just published a retrospective review in JAMA Facial Plastic Surgery.

In the 11-year retrospective review of medical records documenting 36 cases of microtia reconstruction, Kristin K. Constantine, M.D., of the Department of Otolaryngology–Head and Neck Surgery, and colleagues divided ears into groups based on material used: high-density porous polyethylene or rib cartilage. Comparisons between groups were made based on age, number of operations required and treatment-related complications. Blinded observers scored ear characteristics including shape, size, location, definition, protrusion and color match.

Researchers found that the polyethylene group was younger than the cartilage group and underwent fewer operations (3.35 vs 4.88 for cartilage group). Definition and size match for ears in this group were rated significantly higher. Two ears with polyethylene grafts had complications, including infection and implant extrusion.

Although the cartilage group did not have infection or extrusion, one ear had minor graft exposure. This group had significantly higher ratings for color match, and better location and protrusion results than the polyethylene group.

Researchers concluded that neither material is the clear winner. While synthetic graft material may provide better aesthetic outcomes in terms of definition and size match, there may be more of a risk for infection or extrusion. Rib cartilage resulted in better color match, location and protrusion, but also required more operations on average. 

The findings were published in the July/August 2014 issue of JAMA Facial Plastic Surgery

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