Health-related quality of life after mandibular resection for oral cancer: Reconstruction with free fibula flap

Abstract

Objectives: Mandibular resection for oral cancer is often necessary to achieve an adequate margin of tumor clearance. Mandibular resection has been associated with a poor health-related quality of life (HRQOL), particularly before free fibula flap to reconstruct the defect. The aim of this study was to evaluate health-related quality of life in patients who have had mandibular resections of oral cancer and reconstruction with free fibula flap. Study Designs: There were 115 consecutive patients between 2008 and 2011 who were treated by primary surgery for oral squamous cell carcinoma, 34 patients had a mandibular resection. HRQOL was assessed by means of the 14-item Oral Health Impact Profile (OHIP-14) and University of Washington Quality of Life (UW-QOL) questionnaires after 12 months postoperatively. Results: In the UW-QOL the best-scoring domain was mood, whereas the lowest scores were for chewing and saliva. In the OHIP-14 the lowest-scoring domain was social disability, followed by handicap, and psychological disability. Conclusions: Mandible reconstruction with free fibula flap would have significantly influenced on patients’quality of life and oral functions. The socio-cultural data show a fairly low level of education for the majority of patients. Key words:Health-related quality of life, free fibula flap, mandibulectomy, UW-QOL, OHIP-14.

A systematic review of validated tools assessing functional and aesthetic outcomes following fibula free flap reconstruction of the mandible

“…In this review, the best domain mean scores for the 3 studies that used OHIP were for handicap, social disability, and psychological disability, whereas the lowest scores were reported for physical disability and functional limitations. 5,13 These results provide evidence about the varying effect that oral cancer surgery has on oral health. Patients report that surgery has brought a lot of disability in their oral function.…”

“…All 7 studies were retrospective case series. 5,[11][12][13][14] In all reviewed studies, 245 patients described underwent segmental resection of the mandible, followed by FFF reconstruction and whose QoL functions were assessed by a validated tool. Among all, the median response rate of patients who returned the QoL questionnaire was 73.8%, with a range of 65.0%-100% (Table 3).…”

“…Results from these studies were reviewed and summarized (Table 4). 5,[11][12][13][14]16 All studies included the UWQoL questionnaire containing 15 domains, 12 of which are disease specific including pain, appearance, activity, recreation, swallowing, chewing, speech, shoulder function, taste, saliva, mood, and anxiety, and 3 are global questions. The domains are scored on a scale ranging from 0 (worst) to 100 (best).…”

“…Three studies used OHIP as an outcome measure. 5,13,14 The OHIP provides a comprehensive measure of dysfunction, discomfort, and disability attributed to oral conditions. OHIP-14 consists of 14 items and OHIP-49 consists of 49 items organized into 7 domains: functional limitation, physical pain, psychological discomfort, physical disability, psychological disability, social disability, and handicap.…”

Impacto do bruxismo do sono na musculatura do sistema estomatognático: avaliação eletromiográfica, força de mordida, função mastigatória, ultrassonográfica e qualidade de vida

“…Existem inúmeros métodos que quantificam a insatisfação do indivíduo em relação à saúde bucal (PRECIADO et al, 2013;FU;LIN, 2013;GOIATO et al, 2014). Dentre estes métodos, se destaca o questionário OHIP-14Br (Oral Health Impact Profile-14Brazil) que mede as percepções dos indivíduos quanto ao impacto social das desordens na cavidade da boca em seu bem estar ao longo de um ano (SCOTT; FORGIE; DAVIS, 2006;YANG et al, 2014;AYALA-LUIS et al, 2014).…”