title: The psychosocial consequences of reconstruction of severe ear defects or third-degree microtia with rib cartilage.
abstract: BACKGROUND
  There are few data focusing on the improvement of psychosocial functioning and self-esteem in patients with congenital or acquired severe auricular defects.
  
  
  OBJECTIVE
  We investigated the satisfaction of patients following auricular reconstruction with rib cartilage.
  
  
  METHODS
  One hundred patients treated for reconstruction with rib cartilage for congenital or traumatic auricular defects have been evaluated retrospectively for changes in self-esteem, performance ability, and psychosocial attitude using a clinically established questionnaire, Frankfurter Selbstkonzeptskalen (FSKN). In addition, patients were asked to judge the new auricle and the thoracic scar using a new questionnaire.
  
  
  RESULTS
  Of 68 patients who took part in this study, almost 90% could integrate the new ear into their body concept. If faced with the same decision for surgery again, 75% would again choose a reconstruction with rib cartilage. More than three-quarters rated the thoracic scar as acceptable in relation to the benefits of the new ear, although one-third felt uncomfortable with the pain and cosmetic appearance of the thoracic scar. According to the results of the FSKN questionnaire, values in psychosocial abilities improved postoperatively. There was no clear change in either self-esteem or performance ability.
  
  
  CONCLUSIONS
  Ear reconstruction with rib cartilage remains, under most circumstances, the procedure of choice for repairing auricular defects. There is a high acceptance of this method among patients, although the impact of the thoracic scar needs to be discussed extensively before surgery. The importance of the surgeon's experience cannot be underestimated, because it determines the aesthetic results and the patient's satisfaction in this challenging area of plastic surgery.
authors.affiliation: Department of Otorhinolaryngology, University of Lübeck, Lübeck, Germany. armin.steffen@hno.uni-luebeck.de
authors.forename: Armin
authors.initials: A
authors.lastname: Steffen
authors.forename: Susanne
authors.initials: S
authors.lastname: Klaiber
authors.forename: Ralf
authors.initials: R
authors.lastname: Katzbach
authors.forename: Stefan
authors.initials: S
authors.lastname: Nitsch
authors.forename: Inke R
authors.initials: IR
authors.lastname: König
authors.forename: Henning
authors.initials: H
authors.lastname: Frenzel
mesh_terms: D000293:Adolescent; D002648:Child; D002921:Cicatrix / Q000523:psychology; D004425:Ear Cartilage / Q000002:abnormalities / Q000601:surgery*; D004426:Ear Deformities, Acquired / Q000523:psychology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D016348:Osseointegration; D019651:Plastic Surgery Procedures / Q000379:methods / Q000523:psychology*; D012272:Ribs / Q000637:transplantation; D012649:Self Concept; D011795:Surveys and Questionnaires; D014182:Transplantation, Autologous; D016896:Treatment Outcome