(042) Appearance Normalization to the Casual Observer Following HNC Surgery

Introduction: Head and neck cancer (HNC) makes up 5% of all cancers, but given the visible nature of the area affected, patients experience a disproportionate disability related to appearance, self-image and quality of life. Using a novel method of objective eye-tracking technology, we hypothesize that plastic and reconstructive surgery following HNC treatment normalizes casual observer focus.

Methods: This is a prospective observational study taking place from September, 2022 to April, 2023. A total of 16 photographs from 4 patients were placed in random order, a preoperative and postoperative anterior and sideview photograph for each patient. All patients had received primary treatment for their HNC followed by a Grecian Urn submentoplasty for neck rejuvenation. After proper calibration of the Tobii Pro Nano, participants viewed each photograph for 6 seconds in a random order, without prior sensitization to the study objective. The primary outcome measurement was total duration of fixations on the neck before and after submentoplasty, using a paired t-test to determine significance.

Results: A total of 83 participants were included in the final analysis- 27 males and 56 females with an average age of 52 (19-88; SD 19.6). The largest difference in mean duration of fixation was observed in sideview photographs of patients 1-4- 163 ms, 360 ms, 205 ms, and 160 ms, respectively (p-value < 0.05). Anterior view were more variable with a mean difference of 94 ms (95% CI -29-216), 99 ms (95% CI -32-231), 41 ms (95% CI -91-173), -51 ms (p-value < 0.05 95% CI -92-(-11)), respectively.

Conclusions: HNC survival rates have increased recently and demanded more focus on quality of life following primary treatment. Rejuvenation surgery to address stigmata of HNC treatment is important in addressing patient concerns with appearance following HNC management. We used a novel method to objectify changes in casual observer focus following rejuvenation treatment, confirming a favorable decrease in onlooker focus on areas of surgery. Greater study is needed to further quantify appearance related quality of life patient concerns and social stigma.