Steffen A, Meyer Zu Natrup C, König I R, Frenzel H, Rotter N
Klinik für Hals-, Nasen- und Ohrenheilkunde, Universität zu Lübeck, Lübeck.
Laryngorhinootologie. 2009 Apr;88(4):247-52. doi: 10.1055/s-0028-1100386. Epub 2008 Dec 8.
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.
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.
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).
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.
肋软骨耳再造术后小耳畸形患者心理社会幸福感的改善主要通过临床评估。虽然有一些前瞻性研究使用成熟的心理问卷并取得了有前景的结果，但这些测试对于临床日常使用来说过于繁琐。因此，我们设计了一个专门用于头颈部区域的简短版本。
临床常用的心理问卷“法兰克福自我概念量表/FSKN”由78个项目组成，用于自我评估表现能力、自尊和心理社会态度。我们将FSKN缩减至13个可能与头颈部整形重建手术相关的项目。对68例患者进行了肋软骨耳再造术后的回顾性分析，并对21例患者进行了前瞻性分析。将前瞻性研究组的术前数据与23例咨询后拒绝任何类型重建的小耳畸形患者的结果进行了比较。
尤其是心理社会能力方面，在回顾性研究组（中位数从138.5分提高；p<0.01）和前瞻性研究组（中位数从126分提高到141分；p=0.01）中，耳再造术后均有改善。我们能够证明FSKN简短版本的变化（中位数分别从51.5分提高到58.5分；p<0.01，从50分提高到56分；p=0.02）。拒绝耳部手术的患者在心理社会能力方面得分更高（中位数从126分提高到154分；p<0.01）。同样，简短版本也清楚地显示了这种差异（中位数从50分提高到65分；p<0.01）。
FSKN简短版本在术前评估和记录重建手术后的心理变化方面具有有前景的潜力。需要进一步研究来验证这一新工具，以获得一种可用于头颈部整形手术临床日常使用的有价值测试。
