title: Patient reported outcome measures in microtia surgery.
abstract: BACKGROUND
  Autologous ear reconstruction for microtia is a complex, multi-stage procedure. The success of the procedure is dependant on how the patient perceives the outcomes of surgery and their overall experience. Patient reported measures are therefore crucial to developing the technique and improving the patient journey.
  
  
  OBJECTIVE
  The aim of this study was to use two reproducible patient reported outcome tools as an objective measure of microtia reconstructive surgery.
  
  
  METHODS
  A retrospective cohort study was performed at Great Ormond Street Hospital (GOSH), London and the Royal Hospital for Sick Children (RHSC), Edinburgh. Two questionnaires were posted to patients with congenital microtia who underwent an autologous ear reconstructive procedure. The first questionnaire - designed by the authors at Great Ormond Street Hospital - measured the patient's perspectives of: ear appearance, the individual aesthetic units and the donor site. The second questionnaire - created by the authors at the Royal Hospital for Sick Children - collected demographic information; and asked general questions regarding ear surgery including psychosocial considerations and satisfaction scores of individual aesthetic units.
  
  
  RESULTS
  The majority of patients were very satisfied with their reconstructed ear (83% at GOSH and 85% at RHSC). High patient satisfaction scores were reported for the lobe of ear and size of the ear. Low satisfaction scores were reported for the antitragus and projection of ear.
  
  
  CONCLUSIONS
  The measures used in this study provide an objective assessment of patient reported experience and outcome that in the future can be used as a means of targeted quality improvement and to benchmark care nationally.
authors.affiliation: Great Ormond Street Hospital, London, United Kingdom. Electronic address: fa347@cam.ac.uk.
authors.forename: Farhana
authors.initials: F
authors.lastname: Akter
authors.affiliation: Royal College of Surgeons of England, London, United Kingdom.
authors.forename: Joanna C
authors.initials: JC
authors.lastname: Mennie
authors.affiliation: Royal Hospital for Sick Children, Edinburgh, United Kingdom.
authors.forename: Ken
authors.initials: K
authors.lastname: Stewart
authors.affiliation: Great Ormond Street Hospital, London, United Kingdom.
authors.forename: Neil
authors.initials: N
authors.lastname: Bulstrode
mesh_terms: D000293:Adolescent; D002648:Child; D065817:Congenital Microtia / Q000601:surgery*; D004431:Ear, External / Q000601:surgery*; D004954:Esthetics; D005260:Female; D006801:Humans; D008297:Male; D013506:Otologic Surgical Procedures; D000071066:Patient Reported Outcome Measures; D017060:Patient Satisfaction; D058996:Quality Improvement; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Microtia; Patient report outcome measures; Patient satisfaction; Quality improvement