Surgical Microtia Reconstruction in Hemifacial Microsomia Patients: Current State and Future Directions
Background:. Hemifacial microsomia (HFM) is one of the most common congenital craniofacial disorders. Among many other features, microtia is present in the large majority of these patients. However, mainly due to the unilateral hypoplastic anatomy, microtia reconstruction among this patient populati...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2022-08-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004486 |
| _version_ | 1811283106867445760 |
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| author | Gabriel Bouhadana, MD Jordan Gornitsky, MD Eli Saleh, MD, MSc Daniel E. Borsuk, MD, MBA, FRCSC Sabrina Cugno, MD, MSc, FRCSC |
| author_facet | Gabriel Bouhadana, MD Jordan Gornitsky, MD Eli Saleh, MD, MSc Daniel E. Borsuk, MD, MBA, FRCSC Sabrina Cugno, MD, MSc, FRCSC |
| author_sort | Gabriel Bouhadana, MD |
| collection | DOAJ |
| description | Background:. Hemifacial microsomia (HFM) is one of the most common congenital craniofacial disorders. Among many other features, microtia is present in the large majority of these patients. However, mainly due to the unilateral hypoplastic anatomy, microtia reconstruction among this patient population remains a reconstructive challenge for plastic surgeons. Given that no clear standards exist, an evidence-based synthesis of the literature was devised.
Methods:. A systematic search of Pubmed, Medline, and Embase was carried out, in accordance with the PRISMA guidelines. Studies discussing surgical microtia reconstruction for HFM patients were retained. Qualitative data regarding study design, challenges addressed, specific recommendations, and their respective strengths/limitations were extracted from each. Retrieved recommendations were consolidated and assigned a level of evidence grade.
Results:. Although only 11 studies were included in this review, these provided 22 main recommendations regarding the eight HFM-specific challenges identified, which were of either grade C (n = 5) or D (n = 17). Included studies addressed construct location (n = 7), the low hairline (n = 6), soft tissue construct coverage (n = 6), earlobe reconstruction (n = 6), construct projection (n = 5), anomalies of the relevant neurovascular systems (n = 2), retroauricular construct coverage (n = 2), and sizing of the construct (n = 2).
Conclusions:. Given the many persisting reconstructive challenges regarding surgical microtia reconstruction for HFM patients, the authors present a comprehensive and evidence-based consolidation of recommendations specific to these challenges. The authors hope this systematic review can appropriately guide plastic surgeons and will ultimately improve care for this patient population. |
| first_indexed | 2024-04-13T02:05:43Z |
| format | Article |
| id | doaj.art-2d1c23d5685646b4b47797ef15bd845c |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-04-13T02:05:43Z |
| publishDate | 2022-08-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-2d1c23d5685646b4b47797ef15bd845c2022-12-22T03:07:29ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742022-08-01108e448610.1097/GOX.0000000000004486202208000-00037Surgical Microtia Reconstruction in Hemifacial Microsomia Patients: Current State and Future DirectionsGabriel Bouhadana, MD0Jordan Gornitsky, MD1Eli Saleh, MD, MSc2Daniel E. Borsuk, MD, MBA, FRCSC3Sabrina Cugno, MD, MSc, FRCSC4From the * Division of Plastic and Reconstructive Surgery, Université de Montréal, Montreal, Quebec, CanadaFrom the * Division of Plastic and Reconstructive Surgery, Université de Montréal, Montreal, Quebec, CanadaFrom the * Division of Plastic and Reconstructive Surgery, Université de Montréal, Montreal, Quebec, CanadaFrom the * Division of Plastic and Reconstructive Surgery, Université de Montréal, Montreal, Quebec, CanadaFrom the * Division of Plastic and Reconstructive Surgery, Université de Montréal, Montreal, Quebec, CanadaBackground:. Hemifacial microsomia (HFM) is one of the most common congenital craniofacial disorders. Among many other features, microtia is present in the large majority of these patients. However, mainly due to the unilateral hypoplastic anatomy, microtia reconstruction among this patient population remains a reconstructive challenge for plastic surgeons. Given that no clear standards exist, an evidence-based synthesis of the literature was devised. Methods:. A systematic search of Pubmed, Medline, and Embase was carried out, in accordance with the PRISMA guidelines. Studies discussing surgical microtia reconstruction for HFM patients were retained. Qualitative data regarding study design, challenges addressed, specific recommendations, and their respective strengths/limitations were extracted from each. Retrieved recommendations were consolidated and assigned a level of evidence grade. Results:. Although only 11 studies were included in this review, these provided 22 main recommendations regarding the eight HFM-specific challenges identified, which were of either grade C (n = 5) or D (n = 17). Included studies addressed construct location (n = 7), the low hairline (n = 6), soft tissue construct coverage (n = 6), earlobe reconstruction (n = 6), construct projection (n = 5), anomalies of the relevant neurovascular systems (n = 2), retroauricular construct coverage (n = 2), and sizing of the construct (n = 2). Conclusions:. Given the many persisting reconstructive challenges regarding surgical microtia reconstruction for HFM patients, the authors present a comprehensive and evidence-based consolidation of recommendations specific to these challenges. The authors hope this systematic review can appropriately guide plastic surgeons and will ultimately improve care for this patient population.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004486 |
| spellingShingle | Gabriel Bouhadana, MD Jordan Gornitsky, MD Eli Saleh, MD, MSc Daniel E. Borsuk, MD, MBA, FRCSC Sabrina Cugno, MD, MSc, FRCSC Surgical Microtia Reconstruction in Hemifacial Microsomia Patients: Current State and Future Directions Plastic and Reconstructive Surgery, Global Open |
| title | Surgical Microtia Reconstruction in Hemifacial Microsomia Patients: Current State and Future Directions |
| title_full | Surgical Microtia Reconstruction in Hemifacial Microsomia Patients: Current State and Future Directions |
| title_fullStr | Surgical Microtia Reconstruction in Hemifacial Microsomia Patients: Current State and Future Directions |
| title_full_unstemmed | Surgical Microtia Reconstruction in Hemifacial Microsomia Patients: Current State and Future Directions |
| title_short | Surgical Microtia Reconstruction in Hemifacial Microsomia Patients: Current State and Future Directions |
| title_sort | surgical microtia reconstruction in hemifacial microsomia patients current state and future directions |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004486 |
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