Cartilage allograft for reconstruction of acquired and congenital total and subtotal auricular defects: A systematic review.

Abstract

Use of autogenous cartilage for ear reconstruction is the gold standard; however, its harvest is associated with morbidity and limited availability in children. This study systematically reviews literature on the safety and efficacy of ear reconstruction with cartilage allograft. A systematic review per the PRISMA guidelines. Patients with a history of acquired or congenital ear defects who underwent reconstruction with cartilage allografts. The search yielded in 178 articles and 10 studies were included. All were retrospective case series or reports. At least 156 ears (150 patients) were reconstructed with cartilage allograft at a mean age of 12.2 years with a median follow-up duration of 48 months. If specified, most auricular defects were total defects (38/40) and congenital (56/61). Non-radiated cadaveric cartilage allograft was the most used material. Among the 156 ears, 72 ears had complications including total resorption (32/72), followed by partial resorption (29/72), extrusion (3/72), infection (3/72), and skin necrosis (2/72). Notably, resorption requiring surgical management was less frequent (18/61). Unplanned reoperation was performed in 23/156 cases. Improvements in function, that is ability to wear glasses and improvement in hearing, were mentioned by 2 patients. Ear reconstruction with cartilage allograft provides the benefits of avoiding donor site morbidity and decreasing operative time. More rigorous and high quality studies are needed to reliably assess its safety as an alternative to autogenous or alloplastic material.