{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T15:08:58Z","timestamp":1788966538588,"version":"build-2803163510"},"reference-count":30,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2021,4,2]],"date-time":"2021-04-02T00:00:00Z","timestamp":1617321600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2021,7]]},"abstract":"\n Objectives\/Hypothesis<\/jats:title>\n To better understand aesthetic patient\u2010reported outcomes and psychosocial quality of life (QOL) after head and neck microvascular reconstruction for benign or malignant tumors.<\/jats:p>\n <\/jats:sec>\n \n Study Design<\/jats:title>\n Single\u2010center prospectively obtained in\u2010office validated questionnaire\u2010based study.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Analysis of prospectively collected surveys at a tertiary care academic center from June 2018 to February 2021. Patients completed two FACE\u2010Q scales: Appearance\u2010Related Psychosocial Distress (ARPD) and Social Function (SF). Survey scores, demographics, operative course, and adjuvant therapy data underwent univariate and multivariable analyses.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n One hundred and three patients completed surveys at a median of 13.5\u2009months postoperatively (interquartile range: 5.2\u201330.8). Mean ARPD from 0 (no distress) to 100 (maximum distress) was 32.4 (standard error of the mean [SEM]: 2.7). Mean SF from 0 (worst functioning) to 100 (best functioning) was 55.5 (SEM: 2.7). Postoperative adjuvant radiation was associated with 13.9% higher ARPD (95% CI: 3.4\u201324.4,\n P<\/jats:italic>\n \u00a0=\u00a0.019) and 10.4% lower SF (95% CI: \u221220.7 to \u22120.1,\n P<\/jats:italic>\n \u00a0=\u00a0.047). Each appearance\u2010related question on the ARPD scale independently predicted impaired SF (\n P<\/jats:italic>\n \u2009<\u2009.001 for all questions). Upon multivariable logistic regression, osteocutaneous reconstruction, compared to soft tissue alone (\n P<\/jats:italic>\n \u00a0=\u00a0.043), and postoperative adjuvant radiation (\n P<\/jats:italic>\n \u00a0=\u00a0.014) were associated with higher levels of ARPD. Age, sex, relationship status, anxiety or depression history, defect location, and hospital stay were not significantly associated with ARPD or SF scores.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Aesthetic outcomes are important determinants of psychosocial QOL following head and neck microvascular reconstruction: an effect that is worsened by adjuvant radiation. Reconstructive surgeons should prioritize aesthetic outcomes, in addition to functional restoration, to optimize social functioning in patients with head and neck tumors.<\/jats:p>\n <\/jats:sec>\n \n Level of Evidence<\/jats:title>\n \n 3\n Laryngoscope<\/jats:italic>\n , 131:E2204\u2013E2211, 2021\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/lary.29548","type":"journal-article","created":{"date-parts":[[2021,4,2]],"date-time":"2021-04-02T04:55:02Z","timestamp":1617339302000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Appearance\u2010Related<\/scp>\n Distress and Social Functioning after Head and Neck Microvascular Reconstruction"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3632-0498","authenticated-orcid":false,"given":"Aaron L.","family":"Zebolsky","sequence":"first","affiliation":[{"name":"Division of Facial Plastic and Reconstructive Surgery Department of Otolaryngology \u2010 Head and Neck Surgery University of California \u2010 San Francisco San Francisco California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9586-5493","authenticated-orcid":false,"given":"Edgar","family":"Ochoa","sequence":"additional","affiliation":[{"name":"School of Medicine University of California \u2010 San Francisco San Francisco California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karam W.","family":"Badran","sequence":"additional","affiliation":[{"name":"Division of Facial Plastic and Reconstructive Surgery Department of Otolaryngology \u2010 Head and Neck Surgery University of California \u2010 San Francisco San Francisco California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chase","family":"Heaton","sequence":"additional","affiliation":[{"name":"Division of Facial Plastic and Reconstructive Surgery Department of Otolaryngology \u2010 Head and Neck Surgery University of California \u2010 San Francisco San Francisco California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Park","sequence":"additional","affiliation":[{"name":"Division of Facial Plastic and Reconstructive Surgery Department of Otolaryngology \u2010 Head and Neck Surgery University of California \u2010 San Francisco San Francisco California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2775-530X","authenticated-orcid":false,"given":"Rahul","family":"Seth","sequence":"additional","affiliation":[{"name":"Division of Facial Plastic and Reconstructive Surgery Department of Otolaryngology \u2010 Head and Neck Surgery University of California \u2010 San Francisco San Francisco California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8986-5961","authenticated-orcid":false,"given":"P. Daniel","family":"Knott","sequence":"additional","affiliation":[{"name":"Division of Facial Plastic and Reconstructive Surgery Department of Otolaryngology \u2010 Head and Neck Surgery University of California \u2010 San Francisco San Francisco California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,4,2]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.29210"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215116000621"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.2880150603"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1999.17.3.1008"},{"key":"e_1_2_6_6_1","first-page":"401","article-title":"Quality of life after oral and oropharyngeal reconstruction with a radial forearm free flap: prospective study","volume":"38","author":"Bozec A","year":"2009","journal-title":"J Otolaryngol Head Neck Surg"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25894"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/DSS.0000000000000253"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00403-019-01957-2"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.20329"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/asj\/sjw078"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000000895"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-020-05725-1"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599819837621"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599819898861"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26796"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-020-05778-2"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2019.03.005"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27937"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-016-5492-9"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjoms.2015.01.019"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-019-05008-4"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40463-015-0092-4"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/lio2.325"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215114002278"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0037-1606537"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijom.2008.05.021"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.10336"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2015.3171"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-015-3053-6"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.29548","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lary.29548","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.29548","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T15:37:22Z","timestamp":1693409842000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.29548"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,2]]},"references-count":30,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2021,7]]}},"alternative-id":["10.1002\/lary.29548"],"URL":"https:\/\/doi.org\/10.1002\/lary.29548","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,2]]},"assertion":[{"value":"2020-12-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-03-24","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-04-02","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}