Johannes van Gemert1, Irene Holtslag2, Andries van der Bilt2, Matthias Merkx3, Ron Koole2, Ellen Van Cann2. 1. Department of Oral and Maxillofacial Surgery (Head: Ron Koole MD, DMD, PhD), University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands. Electronic address: j.t.m.vangemert@umcutrecht.nl. 2. Department of Oral and Maxillofacial Surgery (Head: Ron Koole MD, DMD, PhD), University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands. 3. Department of Oral and Maxillofacial Surgery (Head: Stefan Bergé MD, DMD, PhD), Radboud University Nijmegen Medical Centre, Geert Grooteplein-Zuid 10, 6525 GA Nijmegen, The Netherlands.
Abstract
OBJECTIVES: Segmental resection of the mandible causes functional, aesthetic and social problems affecting health-related quality of life (HRQoL). It is often assumed that reconstruction with composite free flaps guarantees better function and aesthetics than bridging the defect with reconstruction plates. METHODS: Using the European Organization for Research and Treatment of Cancer questionnaires (EORTC QLQ-C30 version 3.0 and EORTC QLQ-H&N35), we compared HRQoL in patients who received free fibula flaps versus reconstruction plates after segmental resection of the lateral mandible. RESULTS: Thirty-seven completed questionnaires (18 fibula reconstructions and 19 patients with reconstruction plates) were available. Reconstruction with a free fibula flap did not provide clear additional benefit to bridging the defect with a reconstruction plate after segmental resection of the lateral mandible. In particular aspects known to have the most impact on HRQoL like swallowing, speech and chewing were not influenced by the type of reconstruction. CONCLUSIONS: Reconstruction of segmental defects of the lateral mandible with free fibula flap and reconstruction plate resulted in comparable HRQoL. If dental rehabilitation by means of dental implants is not anticipated in the fibula, then plate reconstruction with adequate soft tissue remains a suitable technique for the reconstruction of segmental defects of the lateral mandible.
OBJECTIVES: Segmental resection of the mandible causes functional, aesthetic and social problems affecting health-related quality of life (HRQoL). It is often assumed that reconstruction with composite free flaps guarantees better function and aesthetics than bridging the defect with reconstruction plates. METHODS: Using the European Organization for Research and Treatment of Cancer questionnaires (EORTC QLQ-C30 version 3.0 and EORTC QLQ-H&N35), we compared HRQoL in patients who received free fibula flaps versus reconstruction plates after segmental resection of the lateral mandible. RESULTS: Thirty-seven completed questionnaires (18 fibula reconstructions and 19 patients with reconstruction plates) were available. Reconstruction with a free fibula flap did not provide clear additional benefit to bridging the defect with a reconstruction plate after segmental resection of the lateral mandible. In particular aspects known to have the most impact on HRQoL like swallowing, speech and chewing were not influenced by the type of reconstruction. CONCLUSIONS: Reconstruction of segmental defects of the lateral mandible with free fibula flap and reconstruction plate resulted in comparable HRQoL. If dental rehabilitation by means of dental implants is not anticipated in the fibula, then plate reconstruction with adequate soft tissue remains a suitable technique for the reconstruction of segmental defects of the lateral mandible.
Authors: Joaquin E Jimenez; Marci Lee Nilsen; William E Gooding; Jennifer L Anderson; Nayel I Khan; Leila J Mady; Tamara Wasserman-Wincko; Umamaheswar Duvvuri; Seungwon Kim; Robert L Ferris; Mario G Solari; Mark W Kubik; Jonas T Johnson; Shaum Sridharan Journal: Oral Oncol Date: 2021-10-26 Impact factor: 5.337