Patients' satisfaction is an important outcome measure in reconstructive surgery and quality assurance is today central in the clinical practice. The aim of this study was to evaluate the patients' satisfaction with the process and final result after reconstruction for congenital microtia. A questionnaire was designed and sent to 78 patients who had undergone unilateral ear reconstruction with autologous rib cartilage during the period 2000-2010. For a multidimensional view the patients answered 42 questions about aesthetic, functional, psychosocial, and clinic-related outcomes. The response rate was 76% (59/78 patients). The patients were generally satisfied with the aesthetic result of the ear and had function gain in being able to wear glasses; however, some patients did report new different functional problems after the operation. Still, almost all patients felt that the ear was a part of them and would have chosen the same operative procedure if they could do it again. The patients were overall highly satisfied with the care process. This surgery-specific questionnaire is an important tool for quality assurance in this clinical practice. These findings can help to improve the preoperative information to meet the patients' notions, expectations, and fears.

Background: Lymphaticovenular anastomosis (LVA) with supramicrosurgical technique has recently gained popularity as a treatment method for patients with lymphedema. The aim of this study was to prospectively evaluate objective changes in leg volume in patients operated with LVA for lymphedema in the lower extremity, and to find positive predictors for the treatment method to facilitate the location of the venules and lymphatic vessels. Patients & Methods: 31 consecutive patients with lymphedema in the lower extremity and positive pitting test were examined with lymphoscintigraphy and indocyanine green (ICG) lymphography. The causes of the lymphedema were either cancer or unknown cause/primary lymphedema. Fourteen of the patients with pathological lymphangiographic patterns were chosen for surgery and 12 of them were operated with one to four LVAs each. The lymphedema volume in the lower extremity was measured preoperatively, 6-and 12 months after surgery according to the truncated cone formula with the patient ś contralateral leg used as control. Ten patients had unilateral lymphedema and two patients had bilateral lymphedema. Results: Five of 12 patients showed between 1-8% edema reductions in the lower extremity after 12 months. With examination considering edema duration, number of anastomoses, radiotherapy and lymph node dissection we found a 6,2% difference in edema reduction between patients who had undergone lymph node dissection and those who had not (p = 0.03). Conclusions: The current study indicates that supramicrosurgery with LVA may reduce edema volumes, where the most distinctive positive predictor for edema reduction with LVAs was previous lymph node dissection.