Functional outcomes following mandibulectomy and fibular free-flap reconstruction.

Autor: Jenkins GW; The James Cook University Hospital, Marton Road, Middlesbrough TS4 3bW, United Kingdom. Electronic address: Glyndwr.jenkins1@nhs.net., Kennedy MP; Newcastle Upon Tyne Hospitals, Freeman Hospital, Freeman Road, High Heaton, Newcastle Upon Tyne NE7 7DN, United Kingdom., Ellabban I; The York Hospital, Wigginton Road, Clifton, York YO31 8HE, United Kingdom., Adams JR; Newcastle Upon Tyne Hospitals, Freeman Hospital, Freeman Road, High Heaton, Newcastle Upon Tyne NE7 7DN, United Kingdom., Sellstrom D; Newcastle Upon Tyne Hospitals, Freeman Hospital, Freeman Road, High Heaton, Newcastle Upon Tyne NE7 7DN, United Kingdom.
Jazyk: angličtina
Zdroj: The British journal of oral & maxillofacial surgery [Br J Oral Maxillofac Surg] 2023 Feb; Vol. 61 (2), pp. 158-164. Date of Electronic Publication: 2023 Jan 02.
DOI: 10.1016/j.bjoms.2022.11.287
Abstrakt: There remains a paucity of evidence with regards to functional outcomes following the reconstruction of segmental defects in the mandible. It is, however, well recognised that oral rehabilitation following head and neck surgery is a driver of improved quality of life outcomes. We present a prospective service review of functional outcomes of a consecutive cohort of patients following segmental mandibulectomy and virtual surgical planning (VSP) composite fibular free-flap reconstruction. Twenty-five patients, who were identified as having a complete dataset with a minimum of 12 months' follow up, ultimately met the inclusion criteria. Validated functional outcome measures were used primarily to assess speech, diet, and swallowing outcomes. The results demonstrate a decline in both speech and swallowing outcomes at three months postoperatively, with a decline of 37% in the Speech Handicap Index from the preoperative baseline, and a decline of 35% in the MD Anderson Dysphagia Inventory score over the same period. The MD Anderson Dysphagia Inventory score improved at 12 months, whereas the Speech Handicap Index did not. Fundamentally a collaborative approach is required between members of the multidisciplinary team (MDT) to enable optimal patient outcomes.
(Copyright © 2022 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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