Rogers Simon N, Lowe Derek, McNally Deborah, Brown James S, Vaughan E David
Regional Maxillofacial Unit, University Hospital Aintree, Aintree Trust, Liverpool, United Kingdom.
J Oral Maxillofac Surg. 2003 Feb;61(2):174-81. doi: 10.1053/joms.2003.50044.
The purpose of this cross sectional study was to evaluate the health-related quality of life of patients following maxillectomy and to compare obturation and free flap reconstruction.
At the Regional Maxillofacial Unit in Liverpool, United Kingdom, between 1992 to 1996, 39 patients underwent maxillectomy for malignant pathology. Of these patients, 28 (10 underwent obturation and 18 underwent free tissue reconstruction) completed a postoperative semi-structured interview. Eight questionnaires were used to test aspects of health-related quality of life and function.
The main findings were the associations between the size of maxillectomy defect and the University of Washington activity (-0.53; P =.005) and recreation (-0.70; P <.001) domains, and with the physical functioning (-0.58; P =.001) and quality of life (-0.51; P =.007) domains of the European Organization for Research and Treatment of Cancer questionnaire. No statistically significant differences were seen between the obturator and free flap groups. Borderline trends were for obturator patients to be more concerned about their appearance, to have more pain and soreness in their mouths, to be more aware of their upper teeth, more self-conscious and less satisfied with their upper dentures, and less satisfied with function.
Similar subjective outcomes were found for both groups, and a larger longitudinal study is needed to test these relationships more rigorously.
本横断面研究旨在评估上颌骨切除术后患者的健康相关生活质量，并比较阻塞器修复和游离皮瓣重建的效果。
在英国利物浦的区域颌面外科中心，1992年至1996年间，39例患者因恶性病变接受了上颌骨切除术。其中28例患者（10例行阻塞器修复，18例行游离组织重建）完成了术后半结构化访谈。使用8份问卷来测试健康相关生活质量和功能的各个方面。
主要主要主要发现为上颌骨切除缺损大小与华盛顿大学活动领域（-0.53；P = 0.005）、娱乐领域（-0.70；P < 0.001），以及与欧洲癌症研究与治疗组织问卷的身体功能领域（-0.58；P = 0.001）和生活质量领域（-0.51；P = 0.007）之间存在关联。阻塞器组和游离皮瓣组之间未观察到统计学上的显著差异。存在一些临界趋势，即使用阻塞器的患者更在意自己的外貌，口腔内疼痛和酸痛更多，对上颌牙齿更在意，更自觉，对上颌假牙满意度更低，对功能满意度也更低。
两组的主观结果相似，需要进行更大规模的纵向研究以更严格地检验这些关系。
