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Rating the aesthetic results after auricular reconstructive surgery for congenital aural atresia with microtia
Njima Schläpfer1, Livia Papp1, Dirk Lehnick2
1Department of Otorhinolaryngology, Head & Neck Surgery, University of Lucerne, Cantonal Hospital of Lucerne, Lucerne, Switzerland.
Objective:
This retrospective study aimed to establish a robust rating system for assessing post-operative outcomes in congenital aural atresia patients undergoing auricular reconstruction. The newly introduced EAR scale, a weighted grading system, not only considers anatomical landmarks but also factors such as ear alignment. In addition, the outer-ear cartilage scale and the visual analogue scale (VAS) were introduced. These scales were compared among themselves and against two established scales.
Methods:
Nine raters assessed 17 eligible patients who underwent auricular reconstruction between 2001 and 2020.
Results:
The study compared inter-rater agreement among scales, with the EAR scale proving the most reliable (Krippendorff's alpha coefficient, α = 0.45), outperforming existing measures. The outer-ear cartilage scale and the VAS exhibited lower inter-rater agreement, indicating inferiority in assessing aesthetic outcomes.
Conclusion:
The EAR scale emerged as an effective tool for evaluating post-operative outcomes in congenital aural atresia auricular reconstruction.
