Tianjin Medical University, 22 Qi-xiang-tai Road, Heping District, Tianjin 300070, PR China.
Department of Oromaxillofacial-Head and Neck Surgery, Tianjin Stomatological Hospital, 75 Dagu Road, Heping District, Tianjin 300041, PR China; Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, 75 Dagu Road, Heping District, Tianjin 300041, PR China.
Oral Oncol. 2022 Sep;132:105980. doi: 10.1016/j.oraloncology.2022.105980. Epub 2022 Jun 21.
The purpose of this retrospective study was to compare the differences in quality of life (QOL) outcomes between the conventional obturator prostheses (COP) and the pedicled submental artery island flap (SAIF) in the reconstruction of Brown IIb maxillary defects.
The QOL of 116 eligible patients who had a lapse ≥ 12 months after the cancer-related maxilla ablation was evaluated by the University of Washington quality of life scale (UW-QOL), Performance Status Scale for Head and Neck (PSS-HN), and Obturator Functioning Scale (OFS).
Patients in the SAIF group reported statistically and clinically significant higher overall QOL scores but lower chewing scores in the UW-QOL scale when compared with those in the COP group (P < 0.05). Clinically significantly higher scores were also observed in the recreation and anxiety domains in the UW-QOL scale for the SAIF group, but there was no statistical significances. The COP group reported more complaints about the nasal leakage when swallowing and the shape of the upper lip, and had a stronger willingness to avoid family or social events in the OFS (P < 0.05).
For patients with Brown IIb defects, SAIF reconstruction can achieve reduced nasal leakage when swallowing, improved upper-lip contour, increased social activity, and superior overall QOL than COP. The inferior chewing function in the SAIF group indicated the need for dental rehabilitation with a conventional denture or osseointegrated implants.
本回顾性研究旨在比较常规赝复体(COP)与带蒂颏下动脉岛状皮瓣(SAIF)修复 Brown IIb 上颌骨缺损在生活质量(QOL)结局方面的差异。
使用华盛顿大学生活质量量表(UW-QOL)、头颈部功能状态量表(PSS-HN)和赝复体功能量表(OFS)对 116 例癌症相关上颌骨切除术后≥12 个月的患者进行 QOL 评估。
与 COP 组相比,SAIF 组患者在 UW-QOL 量表中报告了统计学和临床意义上更高的总体 QOL 评分,但咀嚼评分较低(P<0.05)。SAIF 组在 UW-QOL 量表的娱乐和焦虑领域也观察到了更高的评分,但无统计学意义。COP 组报告在吞咽和上唇形状方面存在更多的鼻漏问题,在 OFS 中更不愿意参加家庭或社交活动(P<0.05)。
对于 Brown IIb 型缺损的患者,SAIF 重建可以减少吞咽时的鼻漏、改善上唇轮廓、增加社会活动和提高总体 QOL,优于 COP。SAIF 组咀嚼功能较差,表明需要使用常规义齿或种植体进行牙齿修复。