Summary
Little is known about the psychosocial improvement of microtic patients following
reconstruction with rib cartilage. Furthermore, no data exist on detailed follow-ups
of patients who refused ear repair. To the best of our knowledge, this is the first
report of a prospective evaluation of psychosocial outcomes with a validated instrument
in ear reconstruction with rib cartilage.
Twenty-one patients, who had undergone rib-cartilage reconstruction to treat a congenital
auricular defect, were evaluated prospectively for psychosocial changes using a clinically
validated questionnaire. In addition, patients were asked to judge the new auricle
and thoracic scar. Twenty-three patients, who decided against an ear reconstruction
following consultation, were analysed for the reasons behind their refusal.
Almost 66% of the treated patients were able to integrate the new ear into their body
concept. If faced with the same surgery decision again, 88% would still choose to
undergo ear reconstruction with rib cartilage. There were strong postoperative improvements
in psychosocial attitude (p=0.02). In our sample, patients who declined ear repair showed higher values of psychosocial
attitude (p=0.006) compared with the preoperative results in treated patients.
Our study shows that the clinically known improvement of psychosocial aspects can
be documented by a validated psychological test. The patient's expectations and surgical
limits of the reconstruction with rib cartilage need detailed discussion prior to
surgery to prevent dissatisfaction despite surgical success. Our data help to accept
a child's denial as these patients have a good psychosocial standing even with an
unrepaired microtia.
Keywords
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Article info
Publication history
Published online: October 05, 2009
Accepted:
September 4,
2009
Received:
December 26,
2008
Footnotes
☆Presented at the Auricular Reconstruction Congress in Edinburgh, Scotland, 10–12 October 2007.
Identification
Copyright
© 2009 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
