Dental Service, Memorial Sloan Kettering Cancer Center, New York, New York.
Epidemiology & Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York.
Head Neck. 2019 Jul;41(7):2123-2132. doi: 10.1002/hed.25666. Epub 2019 Feb 13.
The goal of this study is to report functional and esthetic outcomes, after fibula free flap (FFF) reconstruction of the mandible for oral cancer, assessed by physicians, nonclinicians, and patients.
Twenty-five long-term survivors from oral cancer after FFF reconstruction were recalled for head and neck examination by surgeons, for photographs and patient-reported outcomes, using EORTC, QLQ-C30, H&N35, and FACE-Q questionnaires.
Physicians reported 64% restoration of functionality compared to normal. Patients reported high scores on QLQ-C30 but lower scores on H&N35. Esthetic scores were reported higher by clinicians than nonclinicians. The decline in function and appearance was attributed to loss of lower dentition, trismus, malocclusion, xerostomia, and tissue atrophy.
To minimize the decline in function and appearance, immediate dental implants in FFF, better reconstruction of the temporomandibular joint, newer methods of radiotherapy to minimize xerostomia and oral exercises to prevent trismus should be considered.
本研究旨在报告 25 例口腔癌患者游离腓骨瓣（FFF）重建下颌后，由医生、非临床医生和患者评估的功能和美观结果。
对 25 例口腔癌 FFF 重建后的长期生存者进行头颈部检查，由外科医生进行拍照和患者报告结果，使用 EORTC、QLQ-C30、H&N35 和 FACE-Q 问卷。
医生报告的功能恢复程度为正常的 64%。患者在 QLQ-C30 上的评分较高，但在 H&N35 上的评分较低。临床医生报告的美观评分高于非临床医生。功能和外观的下降归因于下颌牙列缺失、张口受限、咬合不正、口干和组织萎缩。
为了最大限度地减少功能和外观的下降，应考虑在下颌 FFF 中即刻植入牙齿、更好地重建颞下颌关节、使用新的放疗方法以减少口干和进行口腔锻炼以预防张口受限。
