Dholam Kanchan P, Sadashiva Karthik M, Gurav Sandeep
1Department of Dental and Prosthetic Surgery, Tata Memorial Hospital, HBNI, Room No 217, Homi Bhabha Block, Dr. E Borges Marg, Parel, Mumbai, 400012 India.
The Sultan's Special Force, Way No 6231, House No 2520, Post box No 331- C.P.O., 111 Azaiba, Muscat, Oman.
J Maxillofac Oral Surg. 2019 Jun;18(2):266-272. doi: 10.1007/s12663-018-1122-3. Epub 2018 May 14.
To study the effect of mandibulectomy with soft tissue reconstruction on quality of life (QOL) and functions of speech and swallowing.
Quality of life of 66 patients was evaluated by using EORTC QLQ-C30 and EORTC-HN35 questionnaires. Speech was evaluated objectively by Dr. Speech software version 4 and subjectively by a single speech therapist along with swallowing. Patients were evaluated preoperatively and 6 months after treatment.
Out of 66 patients, 57 followed up postoperatively. Comparison of preoperative and postoperative QOL, speech, and swallowing was done by using paired 't' test or Wilcoxon signed-rank test as per distribution. When evaluated by EORTC QLQ-C30 and EORTC-HN35, statistically significant difference was found in the domains of physical function, fatigue, nausea-vomiting, dyspnea and appetite loss, pain, nutrition, swallowing speech and dry mouth. Significant difference was found in speech (maximum intensity) and most of the domains of swallowing.
In EORTC QLQ-C30 questionnaire, all functional scales showed deterioration with maximum in physical function. Symptom scales showed worsening but significant improvement was found in pain when evaluated by EORTC-HN35. However, the global health status/QL was found to be improved marginally.
研究下颌骨切除术联合软组织重建对生活质量（QOL）以及言语和吞咽功能的影响。
采用欧洲癌症研究与治疗组织（EORTC）生活质量核心问卷（QLQ-C30）和EORTC头颈部癌症特异性问卷（EORTC-HN35）对66例患者的生活质量进行评估。使用Dr. Speech软件4版对言语进行客观评估，并由一名言语治疗师对言语和吞咽进行主观评估。在术前和治疗后6个月对患者进行评估。
66例患者中，57例进行了术后随访。根据数据分布情况，采用配对t检验或Wilcoxon符号秩检验对术前和术后的生活质量、言语和吞咽情况进行比较。使用EORTC QLQ-C30和EORTC-HN35进行评估时，在身体功能、疲劳、恶心呕吐、呼吸困难、食欲减退、疼痛、营养、吞咽、言语和口干等领域发现有统计学意义的差异。在言语（最大强度）和大多数吞咽领域发现有显著差异。
在EORTC QLQ-C30问卷中，所有功能量表均显示恶化，其中身体功能恶化最为明显。症状量表显示情况恶化，但使用EORTC-HN35评估时疼痛有显著改善。然而，整体健康状况/生活质量仅略有改善。
