The Psychologic and Psychosocial Impact of Otoplasty on Children and Adults

Papadopulos, Nikolaos Α.; Niehaus, Richard; Keller, Emanuel; Henrich, Gerhard; Papadopoulos, Othon; Staudenmaier, R.; Kovâcs, László; Herschbach, Peter; Pototschnig, Hanno; Machens, Hans‐Günther

doi:10.1097/scs.0000000000001990

Cited by 25 publications

(20 citation statements)

References 22 publications

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“…Three separate age groups were used for the analysis with children, adolescents, and adults, all reporting an improvement in health and psychological well-being. 2 …”

Section: Discussionmentioning

confidence: 99%

“… 1 It is well known that children affected by cosmetic deformities of the external ear are more likely to be bullied, suffer from psychological distress, and subsequently play truant. 2 Children with prominent ears are often bullied at school and are also subjected to teasing by family members. 3 , 4 These children are not only more likely to be depressed, but they are also more likely to socially and economically disadvantage themselves by not attending education.…”

Section: Introductionmentioning

confidence: 99%

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A retrospective study of patient outcomes and satisfaction following pinnaplasty

Hope¹,

Smith²,

Cullen

et al. 2016

PROM

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IntroductionUp to 5% of all children have prominent ears. Psychological distress and bullying adversely affect these children and can cause significant social exclusion. In times of austerity, cosmetic procedures such as surgical correction of prominent ears are felt to be an unnecessary cost to the health service.Materials and methodsA retrospective case note review of all patients undergoing pinnaplasty was undertaken. Postoperative outcomes were compared against the Royal College of Surgeons of England standards. The Glasgow Benefit Inventory, a validated post-intervention questionnaire, was then posted out to all patients.ResultsA total of 72 patients were identified. Average age at procedure was 13 years. Eleven patients were above the age of 19 years. Twenty-eight patients were male and forty-four female. Sixty-two cases underwent bilateral pinnaplasty. No patients developed hematoma, and there were no readmissions within 30 days of surgery. Twenty-nine patients responded to the questionnaire (40%), of whom 27 reported a positive impact on their psychosocial well-being with a mean score of 36.ConclusionPinnaplasty offers patients an opportunity to alleviate the psychological distress of bullying and harassment secondary to the appearance of prominent ears.

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“…Three separate age groups were used for the analysis with children, adolescents, and adults, all reporting an improvement in health and psychological well-being. 2 …”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A retrospective study of patient outcomes and satisfaction following pinnaplasty

Hope¹,

Smith²,

Cullen

et al. 2016

PROM

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show abstract

“…Another example of prejudice is that some conditions are considered more distressing for children than for adults [3,68]. In practice, some procedures, such as otoplasty, are reimbursed only for children and adolescents and not for adults [3,68], even though the procedure might reduce suffering in all age groups [69,70].…”

Section: Statistical Normalitymentioning

confidence: 99%

An ethics analysis of the rationale for publicly funded plastic surgery

Sandman

Hansson

2020

BMC Med Ethics

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Background Healthcare systems are increasingly struggling with resource constraints, given demographic changes, technological development, and citizen expectations. The aim of this article is to normatively analyze different suggestions regarding how publicly financed plastic surgery should be delineated in order to identify a well-considered, normative rationale. The scope of the article is to discuss general principles and not define specific conditions or domains of plastic surgery that should be treated within the publicly financed system. Methods This analysis uses a reflective equilibrium approach, according to which considered normative judgements in one area should be logically and argumentatively coherent with considered normative judgements and background theories at large within a system. Results and conclusions In exploring functional versus non-function conditions, we argue that it is difficult to find a principled reason for an absolute priority of functional conditions over non-functional conditions. Nevertheless, functional conditions are relatively easier to establish objectively, and surgical intervention has a clear causal effect on treating a functional condition. Considering non-functional conditions that require plastic surgery [i.e., those related to appearance or symptomatic conditions (not affecting function)], we argue that the patient needs to experience some degree of suffering (and not only a preference for plastic surgery), which must be ‘validated’ in some form by the healthcare system. This validation is required for both functional and non-functional conditions. Functional conditions are validated by distinguishing between statistically normal and abnormal functioning. Similarly, for non-functional conditions, statistical normality represents a potential method for distinguishing between what should and should not be publicly funded. However, we acknowledge that such a concept requires further development.

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“… 10 Given the lack of ear-specific PRO instruments, researchers have used generic measures. 11 – 15 Although generic instruments measure psychosocial concerns, which are important to people with ear anomalies, the use of such tools alone misses the opportunity to measure the key outcome targeted by surgery, that is, satisfaction with ear appearance. Recently, a PRO measure for microtia was published.…”

Section: Introductionmentioning

confidence: 99%

Development of a New Patient-reported Outcome Measure for Ear Conditions: The EAR-Q

Klassen

Longmire

Bulstrode

et al. 2018

Plastic and Reconstructive Surgery - Global Open

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Background:Patient-reported outcome measures are widely used to improve health services and patient outcomes. The aim of our study was to describe the development of 2 ear-specific scales designed to measure outcomes important to children and young adults with ear conditions, such as microtia and prominent ears.Methods:We used an interpretive description qualitative approach. Semi-structured qualitative and cognitive interviews were performed with participants with any type of ear condition recruited from plastic surgery clinics in Canada, Australia, United States, and United Kingdom. Participants were interviewed to elicit new concepts. Interviews were audio-recorded, transcribed, and coded using the constant comparison approach. Experts in ear reconstruction were invited to provide input via an online Research Electronic Data Capture survey.Results:Participants included 25 patients aged 8–21 years with prominent ears (n = 9), microtia (n = 14), or another condition that affected ear appearance (n = 2). Analysis of participant qualitative data, followed by cognitive interviews and expert input, led to the development and refinement of an 18-item ear appearance scale (eg, size, shape, look up close, look in photographs) and a 12-item adverse effects scale (eg, itchy, painful, numb).Conclusions:The EAR-Q in currently being field-tested internationally. Once finalized, we anticipate the EAR-Q will be used in clinical practice and research to understand the patient’s perspective of outcomes following ear surgery.

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The Psychologic and Psychosocial Impact of Otoplasty on Children and Adults

Abstract: Therapeutic, III: Retrospective cohort or comparative study.

Cited by 25 publications

References 22 publications

A retrospective study of patient outcomes and satisfaction following pinnaplasty

A retrospective study of patient outcomes and satisfaction following pinnaplasty

An ethics analysis of the rationale for publicly funded plastic surgery

Development of a New Patient-reported Outcome Measure for Ear Conditions: The EAR-Q

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