The impact of nasal reconstruction following tumour resection on psychosocial functioning, a clinical-empirical exploration
Sanne E. Moolenburgh 1, Marc A.M. Mureau 1, Sarah L. Versnel 1, Hugo J. Duivenvoorden 2, Stefan O. P. Hofer 1 3
1Department of Plastic and Reconstructive Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands
2Department of Medical Psychology and Psychotherapy, Erasmus University Medical Center, NIHES, Rotterdam, The Netherlands
3Division of Plastic Surgery, Department of Surgery and Department of Surgical Oncology, University Health Network, Toronto, Ontario, Canada
Objective: Total or partial nasal amputation following tumour resection is one of the more severe facial disfigurements. Successful nasal reconstruction can therefore be regarded as restoring a patient's psychosocial health. The objective of this study, therefore, was to evaluate different determinants of patient's psychosocial functioning and their effect on patient satisfaction after nasal reconstruction.
Methods: A cross-sectional study with a case-control study design was conducted. Level of satisfaction with nasal appearance and psychosocial functioning were assessed with validated questionnaires.
Results: A total of 30 consecutive patients were recruited. They were treated between November 2001 and May 2005 for (sub)total nasal defects following radical tumour resection. For the control group 99 consented to participate. Social anxiety and avoidance were scored significantly higher within the patient group (p=0.01). Patients cope significantly more passive than controls (p=0.04). Self-esteem levels did not differ significantly between patients and controls (p=0.22). Determinants of satisfaction with nasal reconstruction were self-esteem (p=0.0001), active coping strategy (p=0.001), and passive coping strategy (p=0.0001).
Conclusion: Nasal reconstruction has an impact on psychosocial functioning of nasal reconstruction patients. In addition, self-esteem and coping strategy are important determinants of satisfaction with nasal reconstruction, and should be held in mind when treating a patient.