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Health-related quality-of-life assessment and surgical outcomes for auricular reconstruction using autologous costal cartilage.
Plastic and Reconstructive Surgery 2012 March
BACKGROUND: This study aims to assess the health-related quality-of-life benefit following auricular reconstruction using autologous costal cartilage in children. In addition, key aspects of the surgical reconstruction are assessed.
METHODS: After auricular reconstruction, patients completed two questionnaires. The first was a postinterventional health-related quality-of-life assessment tool, the Glasgow Benefit Inventory. A score of 0 signifies no change in health-related quality-of-life, +100 indicates maximal improvement, and -100 indicates maximal negative impact. The second questionnaire assessed surgical outcomes in auricular reconstruction across three areas: facial integration, aesthetic auricular units, and costal reconstruction. These were recorded on a five-point ordinal scale and are presented as mean scores of a total of 5.
RESULTS: The mean total Glasgow Benefit Inventory score was 48.1; significant improvements were seen in all three Glasgow Benefit Inventory subscales (p < 0.0001). A mean integration score of 3.8 and a mean aesthetic auricular unit reconstruction score of 3.4 were recorded. Skin color matching (4.3) of the ear was most successfully reconstructed and auricular cartilage reconstruction scored lowest (3.5). Of the aesthetic units, the helix scored highest (3.6) and the tragus/antitragus scored lowest (3.3). Donor-site reconstruction scored 3.9. Correlation analysis revealed that higher reconstruction scores are associated with a greater health-related quality-of-life gain (r = 0.5). Ninety-six percent of patients would recommend the procedure to a friend.
CONCLUSIONS: Auricular reconstruction with autologous cartilage results in significant improvements in health-related quality-of-life. In addition, better surgical outcomes lead to a greater improvement in health-related quality-of-life. Comparatively poorer reconstructed areas of the ear were identified so that surgical techniques may be improved.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
METHODS: After auricular reconstruction, patients completed two questionnaires. The first was a postinterventional health-related quality-of-life assessment tool, the Glasgow Benefit Inventory. A score of 0 signifies no change in health-related quality-of-life, +100 indicates maximal improvement, and -100 indicates maximal negative impact. The second questionnaire assessed surgical outcomes in auricular reconstruction across three areas: facial integration, aesthetic auricular units, and costal reconstruction. These were recorded on a five-point ordinal scale and are presented as mean scores of a total of 5.
RESULTS: The mean total Glasgow Benefit Inventory score was 48.1; significant improvements were seen in all three Glasgow Benefit Inventory subscales (p < 0.0001). A mean integration score of 3.8 and a mean aesthetic auricular unit reconstruction score of 3.4 were recorded. Skin color matching (4.3) of the ear was most successfully reconstructed and auricular cartilage reconstruction scored lowest (3.5). Of the aesthetic units, the helix scored highest (3.6) and the tragus/antitragus scored lowest (3.3). Donor-site reconstruction scored 3.9. Correlation analysis revealed that higher reconstruction scores are associated with a greater health-related quality-of-life gain (r = 0.5). Ninety-six percent of patients would recommend the procedure to a friend.
CONCLUSIONS: Auricular reconstruction with autologous cartilage results in significant improvements in health-related quality-of-life. In addition, better surgical outcomes lead to a greater improvement in health-related quality-of-life. Comparatively poorer reconstructed areas of the ear were identified so that surgical techniques may be improved.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
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