Functional outcomes and patient satisfaction after vascularized osteocutaneous scapula flap reconstruction of the mandible in patients with benign or cancerous tumours

• Published in: International journal of oral and maxillofacial surgery 2014-11, Vol.43 (11), p.1330-1338
• Main Authors: Mochizuki, Y, Omura, K, Harada, H, Marukawa, E, Shimamoto, H, Tomioka, H
• Format: Article
• Language: English
• Subjects: Adult; Aged; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - surgery; Dental Occlusion; Dentistry; Female; Humans; Longitudinal Studies; Male; Mandibular Neoplasms - pathology; Mandibular Neoplasms - surgery; mandibulectomy; Mastication; Middle Aged; Oral Surgical Procedures - methods; Patient Satisfaction; pre- and postoperative masticatory force; Reconstructive Surgical Procedures - methods; Recovery of Function; Scapula - transplantation; scapula bone reconstruction; solid food masticatory ability; Speech Intelligibility; subjective satisfaction; Surgery; Surgical Flaps - blood supply; Treatment Outcome
• ISSN: 0901-5027; 1399-0020
• DOI: 10.1016/j.ijom.2014.06.012

Abstract Pre- and postoperative longitudinal assessment of oral functions including masticatory force, masticatory ability with solids, speech intelligibility, and subjective satisfaction was conducted for patients who underwent vascularized osteocutaneous scapula flap reconstruction after mandibulectomy. Postoperative changes in oral function and patient satisfaction were examined in relation to tumour type (i.e., cancerous vs. benign). A change in masticatory force was associated with a reduction in the number of occlusal support zones after surgery and clearly differed by tumour type. Despite all patients showing reduced masticatory force postoperatively, all were satisfied with the improvements in eating and chewing, which were greater in patients with benign tumours than in those with cancerous tumours. Although both groups of patients expressed satisfaction with the aesthetic appearance after surgery, patients with cancerous tumours were more satisfied. However, both groups showed decreased speech intelligibility scores and lower satisfaction with speech after surgery. Preoperative support in the form of reassurance and helping to alleviate anxiety about postoperative appearance would be beneficial for all patients, with additional support provided based on the specific tumour type.