Millsopp Lynne, Brandom Louise, Humphris Gerry, Lowe Derek, Stat C, Rogers Simon
Pembroke Place, Liverpool University Dental Hospital, Liverpool, UK.
Br J Oral Maxillofac Surg. 2006 Oct;44(5):358-63. doi: 10.1016/j.bjoms.2005.07.017. Epub 2005 Oct 19.
Disfigurement after operations for oral and oropharyngeal cancer is an important issue. Our aim was to review the casenotes of patients who reported distress in the appearance domain of the University of Washington Quality of Life Scale (UWQOL) and to find out what help they were given. Of 278 patients with previously untreated oral and oropharyngeal squamous cell carcinoma treated between 1995 and 1999, 114 (41%) were concerned about their appearance. Factors that correlated with these concerns included tumours more than 2cm in size, T2 or worse stage, free tissue reconstruction, segmental mandibular resection, and neck dissection. In only 7 of the 114 was there any mention of the patient's appearance in the clinic notes, of whom 4 were given help (2 scar revisions and 2 oral rehabilitations). This study suggests that patients' concerns about disfigurement are poorly recognised in routine clinical practice and supports the principle of using the UWQOL scale to discuss problems of appearance with patients.
口腔和口咽癌手术后的容貌损毁是一个重要问题。我们的目的是回顾那些在华盛顿大学生活质量量表（UWQOL）的外貌领域报告有苦恼的患者的病历，并了解他们得到了哪些帮助。在1995年至1999年间接受治疗的278例先前未经治疗的口腔和口咽鳞状细胞癌患者中，114例（41%）担心自己的容貌。与这些担忧相关的因素包括肿瘤大小超过2厘米、T2期或更晚期、游离组织重建、下颌骨节段性切除和颈部清扫术。在114例患者中，只有7例在临床记录中提到了患者的容貌，其中4例得到了帮助（2例瘢痕修复和2例口腔修复）。这项研究表明，在常规临床实践中，患者对容貌损毁的担忧未得到充分认识，并支持使用UWQOL量表与患者讨论外貌问题的原则。
