Steffen Armin, Klaiber Susanne, Katzbach Ralf, Nitsch Stefan, König Inke R, Frenzel Henning
Department of Otorhinolaryngology, University of Lübeck, Lübeck, Germany.
Aesthet Surg J. 2008 Jul-Aug;28(4):404-11. doi: 10.1016/j.asj.2008.06.003.
There are few data focusing on the improvement of psychosocial functioning and self-esteem in patients with congenital or acquired severe auricular defects.
We investigated the satisfaction of patients following auricular reconstruction with rib cartilage.
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.
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.
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.
关注先天性或后天性严重耳廓缺损患者心理社会功能和自尊改善的数据较少。
我们调查了肋软骨耳廓再造术后患者的满意度。
使用临床既定问卷法兰克福自我概念量表（FSKN），对100例因先天性或外伤性耳廓缺损接受肋软骨再造治疗的患者进行回顾性评估，以了解其自尊、行为能力和心理社会态度的变化。此外，还要求患者使用一份新问卷对新耳廓和胸部瘢痕进行评价。
在参与本研究的68例患者中，近90%能够将新耳朵融入其身体概念。如果再次面临相同的手术决策，75%的患者会再次选择肋软骨再造。超过四分之三的患者认为相对于新耳朵的益处，胸部瘢痕是可以接受的，尽管三分之一的患者对胸部瘢痕的疼痛和外观感到不适。根据FSKN问卷结果，心理社会能力值术后有所改善。自尊或行为能力没有明显变化。
在大多数情况下，肋软骨耳廓再造仍是修复耳廓缺损的首选方法。患者对该方法的接受度较高，尽管术前需要广泛讨论胸部瘢痕的影响。外科医生经验的重要性不可低估，因为它决定了在这一具有挑战性的整形手术领域的美学效果和患者满意度。
