Factors affecting aesthetic results in patients undergoing craniofacial reconstruction following maxillofacial trauma.

Objectives: To investigate the factors influencing the cosmetic outcomes and prognosis of patients undergoing maxillofacial trauma reconstruction.

Methods: A retrospective analysis was conducted on the clinical data of 335 patients who underwent maxillofacial trauma surgery criteria at Yunfu People's Hospital from March 2016 to June 2023. The Face-Q facial cosmetic rating scale was utilized to evaluate outcomes, with scores above 60 deemed the good prognosis group (n=234) and scores below 60 as the poor prognosis group (n=101). Two groups were compared in terms of demographic data, type of trauma, clinical presentation, intraoperative indicators, postoperative serum parameters and nutritional levels, Hamilton Anxiety Scale (HAS), Pittsburgh Sleep Quality Index (PSQI) sleep quality scores. Postoperative recovery and the incidence of complications were documented. Correlation analysis was performed, and Logistic regression analysis was used to determine influencing factors.

Results: Patients in the good prognosis group were significantly younger than those in the poor prognosis group (38.15 ± 10.32 vs. 46.69 ± 12.15, P < 0.001). Postoperative protein intake (65.81% vs. 33.66%, P < 0.001) and levels of anxiety (5.57 ± 1.52 vs. 6.61 ± 1.47, P < 0.001) were also better in the good prognosis group. There were significant differences in scar formation (5.57 ± 1.52 vs. 6.61 ± 1.47, P < 0.001), postoperative complications (2.56% vs. 8.91%, P=0.022) and scar hypertrophy (1.28% vs. 6.93%, P=0.015) between the two groups. Logistic regression analysis revealed that age (OR=1.07, 95% CI: 1.039-1.109), protein intake adequacy (OR=0.297, 95% CI: 0.141-0.625), HAS scores (OR=1.295, 95% CI: 1.011-1.658), infection (OR=11.579, 95% CI: 2.656-52.274), and Vancouver Scar Scale (VSS) score (OR=15.672, 95% CI: 7.379-33.285) were significantly associated with aesthetic outcomes. The ROC analysis showed that their combined prediction had an AUC of 0.920, indicating good predictive value.

Conclusions: Younger age, adequate protein intake, lower anxiety scores, better scar assessment, and lower infection rates were associated with better prognosis. These findings emphasize the importance of addressing these factors to optimize outcome in craniofacial trauma reconstruction.