[Analysis of psychosocial changes following ear reconstruction with rib cartilage - development of a short test].
BACKGROUND
The improvement of psychosocial well being in patients with microtia after ear reconstruction with rib cartilage is mainly assessed clinically. There are first prospective studies with established psychological questionnaires showing promising results but these tests are too extensive for everyday-use in clinical routine. Therefore, we examined a self-designed short version for the specific use in the head-neck-region.


METHODS
The clinically established psychological questionnaire "Frankfurter Selbstkonzeptskalen/FSKN" consists of 78 items for self-assessment of performance abilities, self-esteem, and psychosocial attitude. We downsized the FSKN to 13 items that might be relevant for plastic reconstructive surgery in the head-neck-region. The pre- and postoperative development after ear reconstruction with rib cartilage was analyzed retrospectively in 68 patients and prospectively in 21 patients. The preoperative data of the prospective study group were compared with the results of 23 patients with microtia who declined any type of reconstruction after consultation.


RESULTS
Especially the results of the psychosocial competence improved after ear reconstruction as well in the retrospective (median values 138,5 to points; p<0,01) as well as in the prospective study group (median values 126 to 141 points; p=0,01). We were able to demonstrate changes in the short version of the FSKN (median values 51,5 to 58,5 points; p<0,01 respectively, 50 to 56 points; p=0,02). Patients who declined ear surgery showed higher values in psychosocial competence (median values 126 to 154 points; p<0,01). Again, the short form displayed this difference clearly (median values 50 to 65 points; p<0,01).


CONCLUSIONS
The short version of the FSKN has promising potential for the preoperative assessment and the documentation of psychological changes following reconstructive surgery. Further studies are necessary to validate the new instrument to obtain a valuable test for use in clinical routine in plastic surgery in the head-neck-region.
Steffen
A
A
Klinik für Hals-, Nasen- und Ohrenheilkunde, Universität zu Lübeck, Lübeck. armin.steffen@uk-sh.de
Meyer Zu Natrup
C
C
König
I R
IR
Frenzel
H
H
Rotter
N
N
D000293:Adolescent; D000328:Adult; D002356:Cartilage / Q000637:transplantation*; D002648:Child; D004431:Ear, External / Q000002:abnormalities* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010555:Personality Inventory / Q000706:statistics & numerical data*; D011446:Prospective Studies; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology*; D019651:Plastic Surgery Procedures / Q000523:psychology*; D012189:Retrospective Studies; D012649:Self Concept; D012917:Social Adjustment