Longitudinal health‐related quality of life after mandibular resection for oral cancer: a comparison between rim and segment

Rogers, Simon N.; Devine, J.C.; Lowe, Derek; Shokar, Parminder; Brown, James S.; Vaugman, E. David

doi:10.1002/hed.10351

Cited by 77 publications

(46 citation statements)

References 22 publications

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“…Similar to previous clinical reports 1,2,20,21) , we show that peri-implant tissue with appropriate contours generates a self-cleaning environment with a decrease in food debris accumulation, maintaining adequate hygiene in the area. Especially after mandibular reconstruction, bulky soft tissue and/or a shallow vestibular sulcus may contribute to an impaired quality of oral hygiene.…”

Section: Discussionsupporting

confidence: 89%

“…Especially after mandibular reconstruction, bulky soft tissue and/or a shallow vestibular sulcus may contribute to an impaired quality of oral hygiene. In this study, corrective preimplant surgery of the vestibular plasty with palatal keratinized mucosal graft at the time of secondary abutment connection surgery was required in all patients, which would be considered a key strategy in accordance with other reports 1,20,21) . The retrospective design, the small number of patients, and the nonrandomized patient selection were limitations of this study.…”

Section: Discussionmentioning

confidence: 76%

“…Rogers SN, et al 21) showed that patients had some problems with masticatory function, even after segmental mandibular resection and mandibular reconstruction, since mandibular defects following advanced oral cancer resection can lead to multiple tooth loss. In such patients, dental implant prosthetic rehabilitation can resolve these functional problems, and the performance of implant-supported rehabilitation has been welldocumented 1,2,20,22) .…”

Section: Discussionmentioning

confidence: 99%

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Computer-assisted Secondary Reconstruction of Mandibular Continuity Defects Using Non-Vascularized Iliac Crest Bone Graft Following Oral Cancer Resection

Kanno

Karino

Yoshino

et al. 2017

J. Hard Tissue Biology.

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The surgical treatment of oral cancers can lead to continuity defects of the mandible. However, microvascularized free-tissue transfer has several limitations, including issues with morbidity of the donor site, complications and a poorly fitted bone geometry. Thus, non-vascularized iliac crest bone grafting, an established conventional technique, remains a feasible alternative for the reconstruction of mandibular continuity defects following advanced oral cancer resection. The purpose of this study was to retrospectively evaluate treatment outcomes using computer-assisted secondary reconstruction of mandibular continuity defects through non-vascularized iliac crest block grafts over a 5-year period and to explore clinical limitations. A total of 11 consecutive advanced oral cancer patients (6 males and 5 females; mean age, 66.6 years) were included in this study. Participants that received computer-assisted secondary non-vascularized iliac crest bone grafts following advanced oral cancer resection with reconstruction plates ± adjuvant chemoradiotherapy or radiotherapy were examined at least 1 year after the mandibular reconstructions. Patient records, as well as radiological and surgical data, were analyzed. Average cancer follow-up time was 18.0 months, and patients that underwent secondary functional and esthetic reconstruction had an average mandibular defect length of 65.5 mm. Complete bone healing was observed in all patients. However, four patients experienced wound dehiscence and surgical site infection, which required local management for complete wound healing. Adjuvant radiotherapy played a signifi cant role (p < 0.05) in reconstruction site morbidity. In addition, eight patients (72.7%) received subsequent dental implants for oral functional rehabilitation. Our results suggest that non-vascularized iliac crest bone grafts are a reliable treatment option for secondary reconstruction of mandibular continuity defects up to a moderate length in oral cancer patients. However, radiotherapy may confound postoperative complications. Limitations of this technique include that the mandibular defect may be lateral and an extraoral approach is required.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 99%

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Computer-assisted Secondary Reconstruction of Mandibular Continuity Defects Using Non-Vascularized Iliac Crest Bone Graft Following Oral Cancer Resection

Kanno

Karino

Yoshino

et al. 2017

J. Hard Tissue Biology.

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“…Lin et al results: swallowing, chewing, speech 11,12,16) The free fibula flap'donor-site pain has already been reported 17,18) . In our study, some patients were worried about the movement of the operated limb, thereby reducing the normal activities.…”

Section: Ameloblastoma Is the Most Common Epithelial Odontogenicmentioning

confidence: 99%

“…An ameloblastoma occasionally demonstrates a clinical course characteristic of malignancy, which may cause significant morbidity and sometimes death 12) . The treatment of large ameloblastoma tumors affecting the jaw bones often requires extensive resections and results in loss of bone continuity, modifying the contour of the face.…”

Section: Ameloblastoma Is the Most Common Epithelial Odontogenicmentioning

confidence: 99%

Measures of Health-related Quality of Life in Huge Ameloblastoma Young Patients after Mandible Reconstruction with Free Fibula Flap

Luo

et al. 2014

J. Hard Tissue Biology.

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Mandibular resection has been associated with a poor health-related quality of life (HRQOL), particularly in young patients with free fibula flap requiring defect reconstruction. The purpose of our study was to evaluate HRQOL of young patients who have had mandibular resections of huge ameloblastoma and free fibula flap reconstruction. The present study assessed 32 young patients who had undergone immediate mandible reconstruction with free fibula flap for huge ameloblastoma using the University of Washington Quality of Life (UW-QOL) Questionnaire and 49-item Oral Health Impact Profile (OHIP-49). Thirty-two of the forty-seven questionnaires were returned (68.08%). Of the 12 disease-specific domains on the UW-QOL, the best 3 scores from the patients were for shoulder, pain and taste, and the worst 3 scores were for chewing, anxiety and mood. On the OHIP-49, the lowest-scoring domain was physical pain, followed by handicap and social disability. A significant effect was found on the HRQOL of young patients with huge ameloblastoma who had undergone immediate mandible reconstruction with free fibula

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Step-by-step surgical technique for mandibular reconstruction with fibular free flap: application of digital technology in virtual surgical planning

Succo

Berrone

Battiston

et al. 2014

Eur Arch Otorhinolaryngol

104

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At present, mandibular reconstruction with a fibular free flap is the gold standard for functional and esthetic rehabilitation after oncological surgery. The purpose of this study was to describe the computer-assisted mandibular reconstruction procedure adopting the customized solution Synthes ProPlan CMF. The study reports five consecutive patients with benign or malignant disease requiring mandibular reconstruction using a microvascular fibular free flap, pre-operative virtual planning, construction of cutting guides and customized laser pre-bent titanium plates. The surgical technique is discussed in a step-by-step fashion. The average post-operative hospital stay was 18 ± 3 days. Ischemia time was recorded in all five cases, with an average of 75 ± 8 min. No problems were encountered in any surgical step and there were no major complications. Excellent precision of cutting guides and a good fit of pre-bent plates were found on both the mandible and fibula. There was excellent precision in bone to bone contact and position between mandible and fibula graft. Measurement data from the pre-operative and post-operative CT scans were compared. The average difference (Δ) between programed segment lengths and CT control segment lengths was 0.098 ± 0.077 cm. Microsurgical mandibular reconstruction using a virtual surgical planning yields significantly shorter ischemia times and allows more precise osteotomies. The technology is becoming increasingly recognized for its ability to optimize surgical outcomes and minimize operating time. Considering that the extent of resection can be wider than predicted, this results in safer modeling of the fibula only after frozen sections have demonstrated the radicality of resection.

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Longitudinal health‐related quality of life after mandibular resection for oral cancer: a comparison between rim and segment

Abstract: After segmental mandibulectomy and reconstruction using composite free tissue transfer, the UW-QOL scores were relatively good. The only 2 difference between rim and segments was noted in the small resections without radiotherapy, and some of this was reflected in differences at baseline.

Cited by 77 publications

References 22 publications

Computer-assisted Secondary Reconstruction of Mandibular Continuity Defects Using Non-Vascularized Iliac Crest Bone Graft Following Oral Cancer Resection

Computer-assisted Secondary Reconstruction of Mandibular Continuity Defects Using Non-Vascularized Iliac Crest Bone Graft Following Oral Cancer Resection

Measures of Health-related Quality of Life in Huge Ameloblastoma Young Patients after Mandible Reconstruction with Free Fibula Flap

Step-by-step surgical technique for mandibular reconstruction with fibular free flap: application of digital technology in virtual surgical planning

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