Reconstructive Techniques in Pediatric Congenital Microtia: A Systematic Review and Meta-analysis

Area of Science:

• Plastic Surgery
• Otolaryngology
• Pediatric Congenital Reconstruction

Background:

• Autografts and allografts are standard materials for microtia reconstruction.
• A systematic review is needed to compare their efficacy in pediatric patients.

Purpose of the Study:

• To systematically review and compare autografts and allografts for pediatric congenital microtia reconstruction.
• To analyze patient demographics, microtia severity, surgical approach, and outcomes.

Main Methods:

• Systematic literature search of MEDLINE, Embase, PubMed, Web of Science, and CINAHL databases (inception–2021).
• Meta-analysis of pooled proportions and continuous variables using a random effects model.
• Stratification of microtia grade (high/low) and comparison between autograft and allograft groups.

Main Results:

• 68 studies included 5,546 pediatric patients (5,382 autografts, 164 allografts).
• Allograft group was younger (8.4 vs. 11.1 years), had higher microtia grade (98% vs. 72%), and fewer syndromic patients (0% vs. 43%).
• Satisfaction (>90%) and complication rates (<10%) were similar for both groups; allografts favored concurrent atresiaplasty/bone conduction implant.

Conclusions:

• Autografts and allografts yield comparable satisfaction and complication rates in pediatric microtia repair.
• Allografts are advantageous for younger patients and combined hearing restoration procedures.
• Further large-scale studies are necessary to ascertain long-term outcomes.