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Scientific Oral Presentation

Pediatric Otolaryngology

Alloplastic versus Autologous Reconstruction for Microtia: A National Database Cost Analysis

Monday, October 19, 2026
8:00 AM - 8:06 AM PT
Location: 409AB

    Presenting Author(s)

  • Jamie A. Schlacter, MD

    Resident
    New York University Grossman School of Medicine
    New York, NY, United States

    • Co-Author(s)

  • Emma Marin Miller, MD

    Resident
    New York University School of Medicine
    New York, New York, United States

    • Senior Author(s)

  • Zahrah M. Taufique, MD

    Pediatric Otolaryngologist and Craniofacial Surgeon
    NYU Langone Health
    Brooklyn, NY, United States

  • DE

    Danielle F. Eytan, MD

    Associate Professor, Facial Plastic & Reconstructive Surgery
    NYU Langone Health
    New york, New York, United States

Disclosure(s):
Jamie A. Schlacter, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Zahrah M. Taufique, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: The primary methods for microtia reconstruction (alloplastic vs. autologous) differ in cost profiles due to variations in operative time, morbidity, and complications. We performed a comparative cost analysis of these two approaches.

Methods: Merative MarketScan database was queried for commercially insured patients of all ages diagnosed with microtia (ICD-9 744.01/23 and ICD-10 Q17.2/ Q16.0) who underwent alloplastic (CPT 11981, 21086) or autologous reconstruction (CPT 21230, 21235) from 2010 to 2025. Demographic and cost data were collected.

Results: A total of 732 cases were identified, of which 415 cases (57%) were alloplastic. Patient sex did not differ between groups, but patients undergoing alloplastic reconstruction were younger (9.7 vs 11.4 years, p = 0.044). Regional variation was observed with the Northeast demonstrating the highest utilization of alloplastic repair (74%). Patients in the autologous reconstruction group had a longer length of stay (0.9 vs. 0 days, p< 0.001) whereas 98.8% of alloplastic cases were discharged the day of surgery. Total payment for the index procedure was nearly double for autologous reconstruction ($18325 vs $9528, p < 0.001). At first surgery, hospital payments were greater for autologous repair ($10164 vs. $335, p< 0.001). In contrast, physician payments were higher for alloplastic reconstruction at index procedure ($9085 vs. $5613, p< 0.001) and remained significantly higher at 30 days ($2016 vs. $43), 6 months ($3591 vs. $576) and 1 year postoperatively ($3943 vs. $1227) (p < 0.001).

Conclusions: In a national database, autologous reconstruction had higher total cost driven by greater hospital payments and was associated with longer length of stay. However, cumulative post-operative costs and physician payments were greater for alloplastic repair. Better understanding these distinct cost profiles may help inform more cost-effective, patient-centered care.