Quality of Life after Mandibular Reconstruction Using Free Fibula Flap and Customized Plates: A Case Series and Comparison with the Literature

Abstract

A single-center retrospective study was conducted to assess health-related quality of life (HRQoL) in 23 consecutive patients undergoing mandibular reconstruction using the computer-aided design (CAD) and computer-aided manufacturing (CAM) technology, free fibula flap, and titanium patient-specific implants (PSIs). HRQoL was evaluated after at least 12 months of surgery using the University of Washington Quality of Life (UW-QOL) questionnaire for head and neck cancer patients. In the 12 single question domains, the highest mean scores were found for “taste” (92.9), “shoulder” (90.9), “anxiety” (87.5), and “pain” (86.4), whereas the lowest scores were observed for “chewing” (57.1), “appearance” (67.9), and “saliva” (78.1). In the three global questions of the UW-QOL questionnaire, 80% of patients considered that their HRQoL was as good as or even better than it was compared to their HRQoL before cancer, and only 20% reported that their HRQoL had worsened after the presence of the disease. Overall QoL during the past 7 days was rated as good, very good or outstanding by 81% of patients, respectively. No patient reported poor or very poor QoL. In the present study, restoring mandibular continuity with free fibula flap and patient-specific titanium implants designed with the CAD-CAM technology improved HRQoL.

Does Free Fibular Flap Reconstruction Affect the Quality of Life in Pediatric Patients With Various Extend of Mandible Defects?

“…Furthermore, assessing QoL in the pediatric population that underwent free fibular flap will be beneficial to assess the oral and mandibular conditions that impact the patient’s daily life. Although there was no gold standard to assess patient QoL up until now, which resulted in several questionnaires available to assess the patient’s condition 23 …”

Application of 3D printed titanium mesh and digital guide plate in the repair of mandibular defects using double-layer folded fibula combined with simultaneous implantation

“…For patients with large mandibular bone defects, the common clinical treatment is segmental mandibular resection and vascularized free flap reconstruction. However, in the actual operation process, the repositioning of the mandibular stump, the restoration of the condyle position, the height and shape of the transplanted bone segment, and the restoration of the occlusal relationship are the key points and difficulties in mandibular reconstruction ( Pamias-Romero et al, 2023 ). Therefore, it is urgent to develop new treatment methods to repair the mandibular bone defects, reconstruct a good facial contour, and restore the occlusal relationship for patients.…”

Developing A Temporary External Fixator (TEF) for Mandibular Reconstruction using Two-Phase QFD and TRIZ Approach

“…The length of hospitalization after mandibular reconstruction exhibits significant interindividual variability influenced by a multitude of factors. The length of stay was reported in a range of 10-55 days with an average of 23 days (Pamias-Romero et al 2023). In addition, medical comorbidities, post-operative complications, and individual pain management requirements can substantially impact the duration of a patient's hospital stay.…”