Comprehensive Analysis of Donor-site Chest Deformities after Autologous Costal Cartilage Microtia Reconstruction: A Systematic Review

Background Autologous costal cartilage has gained widespread acceptance as an important material for ear reconstruction in patients with microtia. Despite its recognition as being “worth the trade-off,” attention should be directed towards donor site deformities. This systematic review focused on existing English literature related to microtia reconstruction and aimed to reveal the incidence of chest wall deformities and assess the effectiveness of various proposed surgical techniques aimed at reducing donor site morbidities. Methods A comprehensive search was conducted on Pubmed and OVID using the keywords “microtia,” and “chest deformity” or “rib harvest.” Articles were screened based on predefined inclusion and exclusion criteria. Data acquisition encompassed patient demographics, employed surgical techniques, methods for evaluating chest deformity, and incidence of associated complications. Results Of the 362 identified articles, 21 met the inclusion criteria. A total of 2,600 cases involving 2,433 patients with microtia were analyzed in this review. Perichondrium preservation during cartilage harvesting led to a significant reduction in chest deformities. However, the wide incidence range (0% to 50%) and a lack of specific assessment method suggested potential underestimation. Computed tomography revealed reduced chest wall growth in both transverse and sagittal directions, resulting in a decreased thoracic area. Innovative surgical techniques have shown promising results in reducing chest deformities. Conclusions Although a quantitative analysis was not feasible, objective evidence of deformities was established through computed tomography scans. This analysis highlighted the need for dedicated studies with larger sample sizes to further advance our understanding of chest wall deformities in microtia reconstruction.