O168 A review of oral and oropharyngeal subsite classification and the impact on long-term speech and swallow function of patients with oncological reconstruction

Autor: L Awad, B Langridge, D Sinha, R Govender, D Noy, P Butler, N Kalavrezos
Rok vydání: 2023
Předmět:
Zdroj: British Journal of Surgery. 110
ISSN: 1365-2168
0007-1323
DOI: 10.1093/bjs/znad101.168
Popis: Introduction The oral cavity and oropharynx can be divided into subsites by function or anatomically. The impact on function following reconstruction of one or more subsites with flap surgery is largely unknown. This systematic review aims to assess how subsites are classified, which assessment tools are used to assess speech and swallow, and long-term outcomes following reconstruction. Methods A systematic review of PubMed, Web of Science and Embase was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). All types of articles were included which contained speech and swallow follow up for oncological flap reconstruction of the oral cavity and oropharynx, except case reports. Results The search resulted in 26 studies with a total of 2,270 patients. Subsites were variably classified ranging from 2-18 per study. Most articles classified subsites anatomically and less commonly functionally grouped subsites. Fewer than half considered the impact of unilateral/bilateral/combination defects. Poorer post-operative function was found for reconstruction of base of tongue, floor of mouth and defects crossing the midline with the best results for lateral reconstruction. The University of Washington Quality of Life Questionnaire (UW-QOL) was the most prevalent measure of function. Subsite was considered impactful for speech and swallow in 76% and 57% of articles respectively. Conclusion Subsite categorisation is extremely variable within the current literature. Subsite reconstruction with flap surgery significantly affects swallow and speech. A consistent and formalised approach, risk stratifying for multiple contributing factors would be useful in clinical pre- and post-operative management.
Databáze: OpenAIRE
Externí odkaz: