The psychosocial impact of microtia and ear reconstruction: A national data-linkage study

Thomas H Jovic; John A G Gibson; Matthew Jovic; Thomas D Dobbs; Rowena Griffiths; Ashley Akbari; Iain S Whitaker

doi:10.3389/fped.2023.1148975

The psychosocial impact of microtia and ear reconstruction: A national data-linkage study

Front Pediatr. 2023 Apr 18:11:1148975. doi: 10.3389/fped.2023.1148975. eCollection 2023.

Authors

Thomas H Jovic^{1

2}, John A G Gibson^{1

2}, Matthew Jovic¹, Thomas D Dobbs^{1

2}, Rowena Griffiths³, Ashley Akbari³, Iain S Whitaker^{1

2}

Affiliations

¹ Reconstructive Surgery and Regenerative Medicine Research Centre, Swansea University, Swansea, United Kingdom.
² Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, United Kingdom.
³ Health Data Research UK, Swansea University, Swansea, United Kingdom.

Abstract

Introduction: Children with visible facial differences are believed to be at increased risk of negative psychosocial behaviours which may manifest as affective disorders. The aim of this study was to determine whether a diagnosis of microtia, and the associated surgical intervention, is associated with psychosocial implications including impaired educational attainment and a diagnosis of an affective disorder.

Methods: A retrospective case-control study was conducted using data linkage to identify patients in Wales with a diagnosis of microtia. Matched controls were sought on the basis of age, gender and socioeconomic deprivation status to yield a total sample size of 709. incidence was calculated using annual and geographic birth rates. Surgical operation codes were used to classify patients into those that had no surgery, autologous reconstruction or prosthetic reconstruction. Educational attainment at 11 years of age, plus a diagnosis of depression or anxiety were used as markers of adverse psychosocial outcomes and the relative risk was attained using logistic regression analyses.

Results: There were no significant associations between a diagnosis of microtia and an increased risk of adverse educational attainment or a risk of an affective disorder diagnosis. Male gender and higher deprivation scores were significantly associated with poorer educational attainment, irrespective of a diagnosis of microtia. Surgical intervention of any nature was also not associated with any increased risk of adverse educational or psychosocial outcomes in microtia patients.

Discussion: Microtia patients in Wales do not appear to be at greater risk of developing affective disorders or impaired academic performance as a result of their diagnosis or associated surgical intervention. Whilst reassuring, the need for appropriate support mechanisms to maintain positive psychosocial wellbeing and academic achievement in this patient cohort is reinforced.

Keywords: anxiety; data science; depression; education; microtia.

Grants and funding

TJ would like to acknowledge funding from the VTCT Foundation and Action Medical Research (GN2782), Microtia UK and BAPRAS. TD and TJ would like to acknowledge funding from the Welsh Clinical Academic Training Programme. IW, MJ, TJ and TD would like to acknowledge funding from the Scar Free Foundation and Health and Care Research Wales. The Scar Free Foundation & Health and Care Research Wales Programme of research in Reconstructive Surgery & Regenerative Medicine has been established in the ReconRegen Research Centre at Swansea University in partnership with Swansea Bay University Health Board.