Single-Stage Microtia Reconstruction: Avoiding Implant Exposure Via Intraoperative Angiography, A Cutting-Edge...

Area of Science:

• Plastic Surgery
• Otolaryngology
• Medical Imaging

Background:

• Microtia, a congenital underdevelopment of the pinna, presents significant reconstructive challenges.
• Intraoperative Indocyanine green (ICG) angiography offers novel visualization of vascular structures.
• Effective vascular visualization is critical for minimizing complications in microtia repair.

Purpose of the Study:

• To evaluate the impact of intraoperative ICG angiography on complication rates in alloplastic microtia reconstruction.
• To analyze the association between ICG utilization and the need for unplanned revision surgery.
• To assess the safety and efficacy of ICG angiography in this patient population.

Main Methods:

• Retrospective cohort review of alloplastic auricular reconstruction cases.
• Analysis of patient demographics, microtia grade, laterality, and ICG use.
• Comparison of complication rates, specifically auricular framework exposures, between ICG and non-ICG groups.

Main Results:

• Twenty-one of 71 ears (29.6%) were reconstructed with ICG angiography.
• Ears reconstructed with ICG had zero auricular framework exposures versus 6 (12%) without ICG (P=0.1).
• No adverse events related to ICG angiography were observed; exposures were successfully salvaged.

Conclusions:

• Intraoperative ICG angiography appears to improve surgical results in microtia reconstruction by ensuring adequate vascular supply.
• The technique shows promise in reducing complications such as auricular framework exposure.
• ICG angiography is a safe and potentially beneficial adjunct in complex microtia repair.