Reconstructive Otoplasty for Microtia

Abstract

Purpose of the study:improve the results of treatment of patients with microtia by improving the method of otoplasty.

Material and methods.The study included 41 patients who underwent various variants of reconstructive otoplasty for congenital defects of the urinary tract in the Department of Plastic and Reconstructive Microsurgery of the State Institution "RSPMTSH named after Academician V. Vakhidov" for the period from 1990 to 2020. The comparison group included 12 (30.8%) patients with microtia, operated on according to B. Brent's method, in the main group - 29 (43.3%) patients operated on according to the improved method. The average age in the main group was 22.4 ± 1.3 years, in the comparison group 19.4 ± 1.9 years.

Results.In total, complications developed in 6 (50%) patients in the comparison group and 3 (10.3%) in the main group. At the same time, the incidence of surgical complications, which subsequently led to the need for re-reconstruction, was 16.7% in the comparison group. There were no such complications in the main group. The share of aesthetic defects was 33.3% in the comparison group and 10.3% in the main group. In total, 5 (41.7%) additional stages of otoplasty were performed in the comparison group, in the main group - 2 (6.9%; 1 - in case of violation of the normal protrusion of the formed UR and 1 more - in case of the formation of an unnatural skin fold). There was also a statistically significant difference in the number of additional plastic surgery stages performed for the complications noted above (criterion χ2 = 7.248; df = 1; p = 0.008). The average duration of surgery in the comparison group for all 4 stages of reconstructive otoplasty was 364.6 ± 6.9 minutes, and in the main group after 2-stage otoplasty according to the proposed method - 195.2 ± 2.7 minutes (t-test = - 22.69; p <0.05). In the comparison group, the second stage was carried out on average after 4.2 ± 0.4 months, whereas in the main group this period was 3.9 ± 0.2 months (t-test = -0.52; p>0.05 ). The duration of the hospital period in the aggregate for all stages of reconstructive otoplasty in the comparison group was 16.6 ± 0.4 days, which was significantly longer than in the main group, where this indicator was 10.1 ± 0.2 days (t-test = -14.43; p <0.05).

Conclusion.The use of the improved method of otoplasty for microtia can shorten the time of surgical rehabilitation and obtain an acceptable aesthetic and functional result of complete reconstructive otoplasty in two stages, promote local tissue growth by 10-12 mm, which makes it possible to cover the implanted cartilaginous frame with a skin flap without tension, and effectively level the risk hair growth along the periphery of the formed auricle.