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鼻唇瓣重建手术后口腔癌患者的临床概况及生活质量评估

Clinical Profile and Quality of Life Assessment of Oral Cancer Patients Following Nasolabial Flap Reconstruction Surgery.

作者信息

Shetty Rohan Kishor, Pradhan Sultan, Kannan Rajan, Doctor Azmat, Surnare Kailash, Jondhale Manoj, Patil Devashri, Shetty Neeraj

机构信息

Fellow Head and Neck Oncology, Department of Surgical Oncology, Prince Aly Khan Hospital, Mazgaon, Mumbai India.

Department of Surgical Oncology, Prince Aly Khan Hospital, Mazgaon, Mumbai India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2020 Jun;72(2):200-207. doi: 10.1007/s12070-019-01760-5. Epub 2019 Nov 7.

Abstract

To evaluate the quality of life (QOL) of oral cancer patients who had undergone surgical reconstruction with nasolabial flap. A cross-sectional study was conducted over a period of 1 year at a tertiary care hospital and 128 subjects were included. The subjective assessment of quality of life using The University of Washington QOL Questionnaire including physical, socio-emotional, composite and overall QOL, Objective assessment of functional mouth opening and Nasolabial crease scar assessment using Vancouver scar scale was done. Majority of the subjects, 98.4% were male. Maximum cases were involving the lower gingivobuccal complex and retromolar trigone followed by buccal mucosa. Majority of the tumors were T2, 53.1% followed by T1, 18.8%. Statistically significant ( < 0.05) difference was found in relation to age, tumor size (T1, T2, T3), absence of adjuvant radiation therapy, presence or absence of neck dissection, tumor site; buccal mucosa and lower gingivobuccal complex plus retromolar trigone and intact bone status in physical functional, social-emotional subscores, composite score and overall QOL assessment. Improved mouth opening postoperatively was statistically significant ( < 0.05) in T1 and T2 lesions of buccal mucosa and lower gingivobuccal complex plus retromolar trigone who did not receive radiation and with intact bone status. Majority of the cases, 36.7% had a nasolabial crease scar score 2. Nasolabial flap is a viable option in the reconstruction of small and medium sized oral defects with good quality of life (QOL) outcome and objective outcome as depicted by significantly improved mouth opening. The aesthetic outcome of nasolabial crease scar is good in our study.

摘要

评估接受鼻唇瓣手术重建的口腔癌患者的生活质量(QOL)。在一家三级护理医院进行了为期1年的横断面研究,纳入了128名受试者。使用华盛顿大学生活质量问卷对生活质量进行主观评估,包括身体、社会情感、综合和总体生活质量;使用温哥华瘢痕量表对功能性开口和鼻唇沟瘢痕进行客观评估。大多数受试者(98.4%)为男性。大多数病例累及下牙龈颊复合体和磨牙后三角,其次是颊黏膜。大多数肿瘤为T2期(53.1%),其次是T1期(18.8%)。在年龄、肿瘤大小(T1、T2、T3)、是否接受辅助放疗、是否进行颈部清扫、肿瘤部位(颊黏膜、下牙龈颊复合体加磨牙后三角)以及身体功能、社会情感子评分、综合评分和总体生活质量评估中的完整骨状态方面,发现了具有统计学意义(<0.05)的差异。在未接受放疗且骨状态完整的颊黏膜、下牙龈颊复合体加磨牙后三角的T1和T2期病变中,术后开口改善具有统计学意义(<0.05)。大多数病例(36.7%)的鼻唇沟瘢痕评分为2分。鼻唇瓣是重建中小型口腔缺损的可行选择,生活质量(QOL)结果良好,客观结果表现为开口明显改善。在我们的研究中,鼻唇沟瘢痕的美学效果良好。

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