Psychosocial status of patients with unilateral and bilateral microtia before auricular reconstruction surgery

Microtia can profoundly influence health-related quality of life. The aim of this study was to investigate the psychosocial status of children and adolescents with unilateral and bilateral microtia before reconstruction surgery. Eighty-six patients with microtia from Peking Union Medical College Hospital (54 with unilateral microtia and 32 with bilateral microtia) responded to structured interviews before reconstruction surgery. The 3 clinically validated questionnaires were the Piers-Harris Children's Self-concept Scale (PHCSS), the Social Anxiety Scale for Children (SASC), and the Children's Loneliness Scale (CLS). Scores from the PHCSS and SASC were compared with Chinese norms. The total scores of the unilateral and bilateral groups were compared for all three questionnaires. Males with unilateral and bilateral microtia had significantly different PHSCC scores than norms (both P < 0.05), and male patients overall had a total score that was 10.61 ± 2.20 points lower than female patients overall. Patients who were 7–9 years-old in the unilateral group and 10 to 13 years-old in the bilateral group had lower total PHSCC scores than norms of the same age (both P < 0.05). There was no significant difference between patients and norms in the 14-16 years-old group. The SASC scores of patients were significantly higher than the norms (P < 0.05). The CLS score was significantly lower in the unilateral group than in the bilateral group (50.17 ± 14.63 vs. 61.38 ± 13.24, P < 0.05), but these two groups did not significantly differ in PHCSS and SASC scores. Compared to Chinese norms, children with unilateral and bilateral microtia had lower self-concept, especially males and those who were 7–13 years-old. Patients with microtia also had increased social anxiety and loneliness. Patients with bilateral microtia were more likely to report loneliness than those with unilateral microtia.