Psychosocial and Quality of Life Outcomes of Prosthetic Auricular Rehabilitation with CAD/CAM Technology

Introduction. The psychosocial and quality of life (QoL) of patients with deformed or missing ears are frequently compromised. The aim of this study is to develop innovative techniques using CAD/CAM technology in prosthetic auricular rehabilitation and provide improvement in the treatment outcomes, including their psychology and QoL. Methods. This is a preliminary clinical cohort study. Six patients requesting for auricular reconstruction were recruited and rehabilitated with implant-supported prosthesis using CAD/CAM technology. Different treatment outcomes including QoL and psychological changes were assessed at different time points. Results. A significant reduction in severity of depressive symptoms (P = 0.038) and an improving trend of satisfaction with life were found at 1 year postoperatively when compared with the preoperative findings. The domain scores in ‘‘Body image”, ‘‘Family/friends/strangers”, and ‘‘Mood” were also significantly higher (P < 0.05) at 1 year postoperatively than 1 week postoperatively. However, only 50% of the patients wear their auricular prosthesis regularly. Conclusion. This preliminary study has confirmed that implant-supported auricular prosthesis could induce improvement in the psychology and QoL with statistically significant differences in the domains of the body image, social interaction, and mood. Our present findings can inform research design and hypotheses generation of future studies.

[1]  J C Lemon,et al.  Extraoral maxillofacial prosthetic rehabilitation at the M. D. Anderson Cancer Center: a survey of patient attitudes and opinions. , 2001, The Journal of prosthetic dentistry.

[2]  C. McGrath,et al.  An evidence-based review of patient-reported outcome measures in dental implant research among dentate subjects. , 2012, Journal of clinical periodontology.

[3]  Edgar Erdfelder,et al.  G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences , 2007, Behavior research methods.

[4]  Michael W. Bridges,et al.  Distinguishing optimism from neuroticism (and trait anxiety, self-mastery, and self-esteem): a reevaluation of the Life Orientation Test. , 1994, Journal of personality and social psychology.

[5]  J Wolfaardt,et al.  Indications and methods of care for aspects of extraoral osseointegration. , 2003, International journal of oral and maxillofacial surgery.

[6]  H. Jeon,et al.  Concealment, depression and poor quality of life in patients with congenital facial anomalies. , 2010, Journal of plastic, reconstructive & aesthetic surgery : JPRAS.

[7]  J E Ware,et al.  Overview of the SF-36 Health Survey and the International Quality of Life Assessment (IQOLA) Project. , 1998, Journal of clinical epidemiology.

[8]  N. Samman,et al.  Change in quality of life after combined orthodontic-surgical treatment of dentofacial deformities. , 2009, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[9]  J. Ostroff,et al.  Posttraumatic Growth After Breast Cancer: Patient, Partner, and Couple Perspectives , 2004, Psychosomatic medicine.

[10]  N. Elsahy Acquired ear defects. , 2002, Clinics in plastic surgery.

[11]  Philip Worthington,et al.  Advanced osseointegration surgery : applications in the maxillofacial region , 1992 .

[12]  P. Tagkalakis,et al.  A fear avoidance model in facial burn body image disturbance. , 2009, Annals of burns and fire disasters.

[13]  J. Szalai,et al.  The Toronto outcome measure for craniofacial prosthetics: a condition-specific quality-of-life instrument. , 2003, The International journal of oral & maxillofacial implants.

[14]  D. Shugars,et al.  Can third molar surgery improve Quality of life? A 6-month cohort study. Discussion , 2003 .

[15]  John Beumer,et al.  Treatment satisfaction with facial prostheses. , 2005, The Journal of prosthetic dentistry.

[16]  P I Brånemark,et al.  A 15-year study of osseointegrated implants in the treatment of the edentulous jaw. , 1981, International journal of oral surgery.

[17]  B. Gandek,et al.  Tests of scaling assumptions and construct validity of the Chinese (HK) version of the SF-36 Health Survey. , 1998, Journal of clinical epidemiology.

[18]  C J Andres,et al.  Hemifacial microsomia and treatment options for auricular replacement: A review of the literature. , 1999, The Journal of prosthetic dentistry.

[19]  John R. Anderson,et al.  The will and the ways: development and validation of an individual-differences measure of hope. , 1991, Journal of personality and social psychology.

[20]  R. Tedeschi,et al.  The Posttraumatic Growth Inventory: measuring the positive legacy of trauma. , 1996, Journal of traumatic stress.

[21]  A. De Sousa Psychological issues in acquired facial trauma , 2010, Indian journal of plastic surgery : official publication of the Association of Plastic Surgeons of India.

[22]  Morton L Perel,et al.  Implant success, survival, and failure: the International Congress of Oral Implantologists (ICOI) Pisa Consensus Conference. , 2008, Implant dentistry.

[23]  J. Wolfaardt,et al.  Osseointegrated Alloplastic versus Autogenous Ear Reconstruction: Criteria for Treatment Selection , 1994, Plastic and reconstructive surgery.

[24]  A. Caputo,et al.  Retention and load transfer characteristics of implant-retained auricular prostheses. , 2007, The International journal of oral & maxillofacial implants.

[25]  K. Noguchi,et al.  Cognitive tendencies of focusing on positive and negative information , 2006 .

[26]  E. Hammerlid,et al.  Long-term study of quality and safety of osseointegration for the retention of auricular prostheses , 1999, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[27]  D. Shek,et al.  Frequency, satisfaction and quality dimensions of perceived parent-adolescent communication among Chinese adolescents in Hong Kong , 2006, International journal of adolescent medicine and health.

[28]  P. Branemark,et al.  Osseointegrated implants in the treatment of the edentulous jaw. Experience from a 10-year period. , 1977, Scandinavian journal of plastic and reconstructive surgery. Supplementum.

[29]  D. Gault,et al.  Patient satisfaction and aesthetic outcomes after ear reconstruction with a Branemark-type, bone-anchored, ear prosthesis: a 16 year review. , 2010, Journal of plastic, reconstructive & aesthetic surgery : JPRAS.

[30]  B. Papsin,et al.  Establishment of a bone-anchored auricular prosthesis (BAAP) program. , 2002, International journal of pediatric otorhinolaryngology.

[31]  Ömer Uysal,et al.  Assessment of health-related quality of life in Turkish patients with facial prostheses , 2013, Health and Quality of Life Outcomes.

[32]  C. W. Cummings,et al.  Cummings otolaryngology--head & neck surgery , 2010 .

[33]  N. Samman,et al.  Quality of life in patients with dentofacial deformity: a comparison of measurement approaches. , 2007, International journal of oral and maxillofacial surgery.

[34]  M. Klein,et al.  A retrospective study of implant-retained auricular prostheses. , 2008, The International journal of oral & maxillofacial implants.

[35]  M. Leary CHAPTER 5 – Social Anxiety, Shyness, and Related Constructs , 1991 .

[36]  S. Ho,et al.  Posttraumatic growth in chinese cancer survivors , 2004, Psycho-oncology.

[37]  L. Cheung,et al.  Dental implants in reconstructed jaws: patients' evaluation of functional and quality-of-life outcomes. , 2003, The International journal of oral & maxillofacial implants.

[38]  A Tjellström,et al.  Osseointegrated implants for replacement of absent or defective ears. , 1990, Clinics in plastic surgery.

[39]  Hanneke Kievit,et al.  Long-Term Quality of Life Assessment in Patients With Auricular Prostheses , 2013, The Journal of craniofacial surgery.

[40]  R. Larsen,et al.  The Satisfaction with Life Scale , 1985, Journal of personality assessment.

[41]  P. Branemark,et al.  The bone‐anchored auricular episthesis , 1981, The Laryngoscope.

[42]  Aman Arora,et al.  Prosthetic rehabilitation of auricular defect: a clinical report , 2013, Prosthetics and orthotics international.

[43]  Arjan Vissink,et al.  Treatment outcome of bone‐anchored craniofacial prostheses after tumor surgery , 2001, Cancer.

[44]  C. R. Snyder,et al.  Development and validation of the State Hope Scale. , 1996, Journal of personality and social psychology.

[45]  C. Sherbourne,et al.  The MOS 36-Item Short-Form Health Survey (SF-36) , 1992 .

[46]  K. Noguchi,et al.  Cultural differences related to positive and negative valence , 2007 .

[47]  T. Schrom,et al.  Untersuchungen zur Lebensqualität nach epithetischem Ohrmuschelersatz , 2010, HNO.

[48]  Jacob Cohen Statistical Power Analysis for the Behavioral Sciences , 1969, The SAGE Encyclopedia of Research Design.

[49]  John P. Robinson,et al.  Measures Of Personality And Social Psychological Attitudes , 1991 .

[50]  T. T. Haug,et al.  The validity of the Hospital Anxiety and Depression Scale. An updated literature review. , 2002, Journal of psychosomatic research.

[51]  R. Friend,et al.  Measurement of social-evaluative anxiety. , 1969, Journal of consulting and clinical psychology.

[52]  M. Longaker,et al.  Auricular reconstruction: indications for autogenous and prosthetic techniques. , 2001, Plastic and reconstructive surgery.

[53]  J. Sachs VALIDATION OF THE SATISFACTION WITH LIFE SCALE IN A SAMPLE OF HONG KONG UNIVERSITY STUDENTS , 2003 .

[54]  Jason Watson,et al.  Construction of an implant-retained auricular prosthesis with the aid of contemporary digital technologies: a clinical report. , 2013, Journal of prosthodontics : official journal of the American College of Prosthodontists.

[55]  A. Cann,et al.  The factor structure of the posttraumatic growth inventory: a comparison of five models using confirmatory factor analysis. , 2008, Journal of traumatic stress.

[56]  T. Waris,et al.  Cold injury of the rat skin. A fluorescence histochemical study of adrenergic nerves, mast cells and patency of cutaneous blood vessels. , 1982, Scandinavian journal of plastic and reconstructive surgery.

[57]  N. Samman,et al.  Impact of orthognathic surgery on quality of life. , 2008, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.