Sharaf M Y, Ibrahim S I, Eskander A E, Shaker A F
Department of Prosthodontics, Faculty of Dentistry, University of Beni-Suef, Beni-Suef, 62511, Egypt.
Department of Prosthodontics, Faculty of Oral and Dental Medicine, University of Cairo, Cairo, Egypt.
Oral Maxillofac Surg. 2018 Mar;22(1):1-11. doi: 10.1007/s10006-018-0679-9. Epub 2018 Jan 31.
To assess the ability of prosthetic rehabilitation versus surgical rehabilitation in improving the QOL for patients with maxillary defects.
A systematic search of PubMed, Scopus data base, Cochrane database, Ovid database, and Latin America & Caribbean database for articles published before September 2017 was performed by two independent reviewers. A manual search of articles published from January 2000 to September 2017 was also conducted. Only English studies were included which evaluate the QoL in patients with head and neck cancers. Any confusion between the two independent reviewers was resolved by means of a moderated discussion between the reviewers.
Five studies fulfilled the inclusion criteria for this study. Many parameters were used regarding evaluation of QOL as the EORTC Head and Neck 35 assessment, UW-QOL, OHIP-14, VAS, OFS, MHI, HAD, Body Satisfaction Scale, Oral symptom check list, Swallowing, Diet consist, Pain control, Postoperative complication, and Speech. Two studies supported the surgical line of treatment for improving the QOL as compared to the prosthetic one; another two studies showed a statistically insignificant improvement in the patients' QOL with the surgical line, while only one revealed insignificant difference in QoL with both lines of treatment.
Surgical rehabilitation provides a better line of treatment in improving the QOL for patients with maxillary defects. On the other hand, prosthetic has proved effectiveness in the immediate post-surgical times as temporary strategy, and it has represented a good alternative when the surgical obturation is compromised.
评估修复性康复与手术康复对改善上颌骨缺损患者生活质量的能力。
由两名独立评审员对PubMed、Scopus数据库、Cochrane数据库、Ovid数据库以及拉丁美洲和加勒比数据库进行系统检索,以查找2017年9月之前发表的文章。还对手动检索2000年1月至2017年9月发表的文章进行了检索。仅纳入评估头颈癌患者生活质量的英文研究。两名独立评审员之间的任何分歧均通过评审员之间的适度讨论来解决。
五项研究符合本研究的纳入标准。在生活质量评估中使用了许多参数,如欧洲癌症研究与治疗组织头颈35项评估、华盛顿大学生活质量问卷、口腔健康影响程度量表、视觉模拟评分法、口腔功能评分、心理健康指数、医院焦虑抑郁量表、身体满意度量表、口腔症状检查表、吞咽、饮食构成、疼痛控制、术后并发症和言语。两项研究支持手术治疗方案比修复治疗方案更能改善生活质量;另外两项研究表明,手术治疗方案在患者生活质量方面的改善在统计学上不显著,而只有一项研究表明两种治疗方案在生活质量方面的差异不显著。
手术康复为改善上颌骨缺损患者的生活质量提供了更好的治疗方案。另一方面,修复治疗已被证明在术后即刻作为临时策略是有效的,并且当手术封闭受损时,它是一个很好的替代方案。