Functional evaluation of mandibular reconstruction with bone free flap. A GETTEC study
| Autor: | J. Longis, Esteban Brenet, J. Lacau Saint Guily, M. Humbert, Philippe Schultz, Alexandre Bozec, J. Davrou, A. Damecourt, Bertrand Baujat, S. Atallah, Pierre Ransy |
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| Přispěvatelé: | CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre de Lutte contre le Cancer Antoine Lacassagne [Nice] (UNICANCER/CAL), UNICANCER-Université Côte d'Azur (UCA), Centre Hospitalier Universitaire de Liège (CHU-Liège), CHU Amiens-Picardie, Centre hospitalier universitaire de Nantes (CHU Nantes), Service d'Oto-Rhino-Laryngologie (O.R.L.) et de Chirurgie Cervico-Faciale [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU), Hôpital Robert Debré, Hôpital Robert Debré-Centre Hospitalier Universitaire de Reims (CHU Reims), Hôpital de Hautepierre [Strasbourg], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier) |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_treatment
Oromandibular reconstruction Dentistry Free flap Free Tissue Flaps 03 medical and health sciences 0302 clinical medicine Swallowing Weight loss medicine Clinical endpoint Humans Speech Mandibular reconstruction Free bone flap 030223 otorhinolaryngology Rehabilitation Bone Transplantation business.industry Plastic Surgery Procedures Gastrostomy 3. Good health Radiation therapy Otorhinolaryngology Fibula DHI score 030220 oncology & carcinogenesis Surgery medicine.symptom Mandibular Reconstruction Functional assessment business [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology |
| Zdroj: | European Annals of Otorhinolaryngology, Head and Neck Diseases European Annals of Otorhinolaryngology, Head and Neck Diseases, Elsevier Masson, 2021, 138 (2), pp.82-88. ⟨10.1016/j.anorl.2020.08.005⟩ |
| ISSN: | 1879-7296 1879-730X |
| Popis: | Objectives To assess the functional results of oromandibular reconstruction by free bone flap, in terms of swallowing, speech and esthetics. Materials and methods A transverse multicenter study included 134 patients reconstructed by free bone flap between 1998 and 2016, with more than 6 months’ follow-up, in 9 centers. A standardized questionnaire collected data on patients and treatment. Study endpoints comprised: weight loss, mouth opening, gastrostomy dependence, type of feeding, and DHI score. The impact of patient baseline characteristics on these functional criteria was explored by uni/multivariate analysis. Results Ninety of the 134 patients had cancer. Fibula flap was mainly used (80%). 94% of reconstructions were primary successes. 71% of patients had pre- or post-operative radiation therapy. 88% had less than 50% lingual resection. 97% recovered oral feeding. 89% had intelligible speech. 86% judged their esthetic appearance as good/average. 9% had dental prosthetic rehabilitation. Radiation therapy and extensive lingual resection significantly impacted swallowing function (P = 0.04 and P = 0.03, respectively). Radiation therapy and oropharyngeal extension significantly increased gastrostomy dependence (P = 0.04 and P = 0.02, respectively). Conclusion Oromandibular reconstruction by free bone flap enabled return to oral feeding in most cases. More than 80% of patients were satisfied with their result in terms of speech and esthetics. However, the rate of dental rehabilitation was low and the rate of complications was high. |
| Databáze: | OpenAIRE |
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