背景:每10,000名新生儿中最多有17.4人受到小生症的影响,但是对于自体修复的黄金标准技术还没有达成共识。在这项研究中,作者比较了两种常见的方法-Brent和Nagata自体肋软骨耳重建技术。对文献进行了系统回顾,并进行了定量荟萃分析,以比较这两种方法的结果。分析的结果包括感染率,坏死,软骨暴露,软骨吸收,血肿,线材挤出,和肥厚性瘢痕.
方法:MEDLINE数据库系统综述,关键字如下:microtia,布伦特,Nagata表演了。排除没有原始数据或患者结局的病例报告和文章。研究选择的包含方法概述在补充数字内容1,http://链接中。lww.com/SCS/F461,below.通过使用Stata对比例进行荟萃分析,分析了每项研究结果的患病率。
结果:共检索到536项潜在研究进行综述。其中12项研究符合纳入标准。四项研究采用了Brent修复方法,其中包括563个耳朵重建。九项研究在2304次重建中实施了Nagata技术。两项研究直接比较了Brent(327耳)和Nagata(471耳)技术。计算的速率和95%置信区间汇总在补充数字内容2,http://链接中。www.com/SCS/F461.在这项研究中确定的Brent和Nagata显微重建技术之间的并发症发生率没有统计学上的显着差异。
结论:Brent和Nagata微生重建技术在感染风险方面没有差异,坏死,软骨暴露,软骨吸收,血肿,线材挤出,或肥厚性疤痕。
BACKGROUND: Up to 17.4 in every 10,000 births are affected by microtia, but no consensus exists on a gold standard technique for autogenous repair. In this study, the authors compare 2 common methods-the Brent and Nagata autogenous costal cartilage ear reconstruction techniques. A systematic
review of the literature and a quantitative meta-analysis to compare the outcomes of these 2 approaches were performed. The outcomes analyzed included rates of infection, necrosis, cartilage exposure, cartilage resorption, hematoma, wire extrusion, and hypertrophic scar.
METHODS: A MEDLINE database systematic
review with the following keywords: microtia, Brent, and Nagata was performed. Case reports and articles without original data or patient outcomes were excluded. Inclusion methods for study selection are outlined in Supplemental Digital Content 1, http://links.lww.com/SCS/F461 , below. The prevalence of outcomes for each study was analyzed through meta-analysis of proportions using Stata.
RESULTS: A total of 536 potential studies were retrieved for
review. Twelve of these studies met inclusion criteria. Four studies utilized the Brent method of repair with the inclusion of 563 ear reconstructions. Nine studies implemented the Nagata technique in 2304 reconstructions. Two studies directly compared the Brent (327 ears) and Nagata (471 ears) techniques. The calculated rate and 95% confidence intervals are summarized in Supplemental Digital Content 2, http://links.lww.com/SCS/F461 . There were no statistically significant differences in complication rates between the Brent and Nagata microtic reconstruction techniques identified in this study.
CONCLUSIONS: The Brent and Nagata microtia reconstruction techniques have no difference in the risk of infection, necrosis, cartilage exposure, cartilage resorption, hematoma, wire extrusion, or hypertrophic scars.