Perioperative Changes in Psychological Status and Associated Factors in Patients With Congenital Ear Deformity: A Prospective Cohort Study

OBJECTIVE: To investigate the dynamic changes in anxiety, depression, and sleep quality in patients with congenital ear deformity during the perioperative period, and to analyze the influencing factors of preoperative psychological status and postoperative psychological improvement. METHODS: This study was designed as a single-center prospective cohort study. Patients with congenital ear deformity who were scheduled to undergo auricular reconstruction, canalplasty, or combined surgery were enrolled. Anxiety, depression, and sleep quality scores were assessed at admission (T0), 1 day before surgery (T1), at discharge (T2), and at 1-month postoperative follow-up (T3). Differences in psychological scores among patients with different degrees of deformity severity were compared, and multivariable linear regression analyses were performed to identify factors associated with preoperative anxiety and postoperative anxiety improvement. RESULTS: Anxiety and depression scores peaked 1 day before surgery and gradually decreased after surgery, with significant improvement observed at 1-month follow-up; sleep quality showed a similar trend but with a smaller magnitude of change. Greater deformity severity was associated with a heavier psychological burden during the perioperative period. Correlation analysis showed that stigma and body image distress were positively correlated with anxiety and depression scores, while self-esteem and family support were negatively correlated. Multivariable analysis indicated that deformity severity, hearing loss, previous surgical history, stigma, and body image distress were important factors associated with preoperative anxiety, whereas family support, self-esteem, and postoperative satisfaction were significantly associated with anxiety improvement. CONCLUSION: Patients with congenital ear deformity experience significant psychological fluctuations during the perioperative period, with the preoperative stage representing a high-risk period. Psychological interventions for high-risk populations and improvements in postoperative satisfaction may enhance psychological outcomes.