Veränderung des Blickmusters in Abhängigkeit des Stadiums der Brustrekonstruktion mittels DIEP Lappenplastik – erste Daten einer Eye-Tracking-Analyse

Zusammenfassung

Hintergrund Die Brustrekonstruktion mittels autologem Gewebe ist fester Bestandteil eines ganzheitlichen Therapiekonzeptes bei Patientinnen mit Mammakarzinom. Während zahlreiche Studien den körperlichen und psychischen Gesundheitszustand von Patientinnen mit Brustkrebs nach Mastektomie und konsekutiver Brustrekonstruktion untersuchen, mangelt es an objektiven Daten zur Beurteilung des Einflusses von Ablatio und Brustrekonstruktion auf die Wahrnehmung von externen Beobachtern. Diese Studie untersucht die Blickmuster bei Betrachtung einer Brust in verschiedenen Stadien der Brustrekonstruktion mittels DIEP Lappenplastik.

Material und Methoden Mittels Eye-Tracking-Technologie wurden die Augenbewegungen von 58 Studienteilnehmer*in- nen beim Betrachten von 2D-Fotografien einer Patientin in den verschiedenen Stadien der Brustrekonstruktion (1. Ablatio, 2. Aufbau mittels DIEP Lappenplastik, 3. MAK Rekonstruktion) analysiert. Die Zeit bis zur ersten Fixierung und die Dauer der Fixierung wurde in jedem Bild für die rechte und linke Brust aufgezeichnet.

Ergebnisse Die Dauer der kompletten Fixierung der operierten Brust zeigte über die verschiedenen Stadien der Brustrekonstruktion insgesamt eine signifikante Abnahme mit p<0,001. Gleichzeitig zeigte sich keine statistisch signifikante Veränderung der Blickdauer auf der nicht-operierten Gegen- seite mit p=0,174. Die Zeit bis zur ersten Blickfixierung der betroffenen Brust zeigte eine signifikante Zunahme über die verschiedenen Rekonstruktionsschritte, mit p<0,001. Bei der Gegenseite zeigte sich kein statistisch signifikanter Unterschied in der Zeit bis zur ersten Fixierung, mit p=0,344.

Schlussfolgerung Die Ablatio mammae und die einzelnen Schritte der Brustrekonstruktion verändern die äußerliche Wahrnehmung von Patientinnen. Im Laufe der einzelnen re- konstruktiven Teilschritte kommt es zu einer zunehmenden Aufhebung der Blickdeviation in Richtung erkrankte Brust.

Abstract

Background Breast reconstruction using autologous tissue is an integral part of breast cancer treatment. While many studies have elucidated the impact of breast reconstruction on patients’ quality of life, self-esteem, sexuality and more, there is a lack of objective data regarding the effects on external observers. Aim of this study was to investigate the change in gaze pattern of independent observers depending on the stage of DIEP-flap breast reconstruction.

Materials and Methods Eye-tracking technology was utilized to analyze the eye movements of 58 study participants while viewing 2 D photographs of a patient after mastectomy and different stages of DIEP-flap breast reconstruction. Time until first fixation and total time of fixation were recorded and con- secutively analyzed for the right and left breast on each image.

Results Overall, the total time of fixation of the operated breast decreased significantly over the different stages of breast reconstruction, with p<0.001. At the same time, there was no statistically significant change in total time of fixation of the non-operated breast, with p=0.174. The time until first fixation showed a significant increase over the different stages of reconstruction for the reconstructed breast, with p<0.001, while no significant differences were found for the opposite breast, with p=0.344.

Conclusion Mastectomy and the individual steps of breast reconstruction alter the perception of breast cancer patients. Over the course of breast reconstruction, the deviation of gaze in the direction of the affected breast is reversed.

Schlüsselwörter

Eye-Tracking - Freie Lappenplastik - Mikrochirurgie

Key words

eye tracking - free flap - microsurgery

Publikationsverlauf

Eingereicht: 26. Februar 2022

Angenommen: 28. Februar 2022

Artikel online veröffentlicht:
09. August 2022

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