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Farghal AE. Fabrication of a Definitive Obturator for a Patient With a Maxillary Defect: A Case Report. Cureus 2023; 15:e50578. [PMID: 38222126 PMCID: PMC10788096 DOI: 10.7759/cureus.50578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2023] [Indexed: 01/16/2024] Open
Abstract
Maxillectomy defects can lead to oroantral communication, causing difficulties with chewing, swallowing, speech, and facial appearance. Prosthodontists play a crucial role in rehabilitating such defects using obturators. This case report presents the fabrication of a definitive obturator with a cast metal framework for a patient who had an acquired maxillary defect and previously experienced issues with an ill-fitting obturator. In this clinical report, the patient's canine teeth on both sides and the premolars and molars on the left side were used for rest placement. Retention was achieved by utilizing the remaining teeth, employing two embrasure Aker clasps on the left molars and premolars and a C-wrought wire clasp on the right canine. A complete palate was designed as the major connector to ensure optimal load distribution to the surrounding tissues. Additionally, an indirect retainer was planned for the right canine. This definitive prosthesis rehabilitated the patient, improving masticatory efficiency, enhancing speech clarity, and improving quality of life.
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Affiliation(s)
- Ahmad E Farghal
- Department of Substitutive Dental Sciences, Taibah University, Medina, SAU
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Du W, Liu G, Zhang W, Zhao N, Shi Y, Peng X. A comparative study of three-dimensional airway changes after fibula flap reconstruction for benign and malignant tumours in the anterior mandible. Int J Oral Maxillofac Surg 2022; 52:633-639. [PMID: 36581476 DOI: 10.1016/j.ijom.2022.12.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 12/16/2022] [Accepted: 12/19/2022] [Indexed: 12/29/2022]
Abstract
Surgical treatment of tumours in the anterior mandible and surrounding tissues may result in defects which can be restored by a fibula free flap. The upper airway may change during this process. The purpose of this retrospective study was to evaluate upper airway changes after fibula free flap reconstruction. A total of 37 patients who underwent anterior mandibulectomy and fibula free flap reconstruction between 2012 and 2020 were recruited. Patients with benign and malignant tumours involving the anterior mandible were included. Spiral computed tomography was performed 1 week preoperatively, 1 week postoperatively, and at> 1 year (range 12-23 months) after surgery. Cross-sectional areas and volumes of the upper airway were measured. Data were analysed by two-way analysis of variance. The upper airway in the malignant tumour group showed an increasing trend, especially at the soft palate and tongue base levels (P < 0.01). In the benign tumour group, the upper airway showed no significant changes. The location of the minimum cross-sectional area moved downwards in both groups, and the area increased in the malignant tumour group during long-term follow-up. Upper airway obstruction is less likely to occur in the long term after surgical resection of anterior mandible malignancies and fibula free flap reconstruction.
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Affiliation(s)
- W Du
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
| | - G Liu
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China; Department of Stomatology, Liangxiang Hospital of Beijing Fangshan District, Beijing, China
| | - W Zhang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
| | - N Zhao
- Institute of Quantitative Economics, School of Economics, Nankai University, Tianjin, China
| | - Y Shi
- Department of Stomatology, Liangxiang Hospital of Beijing Fangshan District, Beijing, China
| | - X Peng
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China.
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Korn P, Spalthoff S, Hammersen J, Krüskemper G, Tavassol F, Winterboer J, Lentge F, Gellrich NC, Jehn P. Socio-demographic aspects and treatment-related factors on oral cancer patients' participation in rehabilitation. GMS INTERDISCIPLINARY PLASTIC AND RECONSTRUCTIVE SURGERY DGPW 2022; 11:Doc07. [PMID: 36300160 PMCID: PMC9577562 DOI: 10.3205/iprs000168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Objectives After resection of an oral carcinoma, patients are faced with physical, psychological, and socioeconomic challenges. Rehabilitation plays an essential role in patients' reintegration into their social and professional environment. This study evaluated whether socioeconomic aspects affect oral cancer patients' participation in rehabilitation treatment. Materials and methods A retrospective analysis was conducted with 1,532 patients following surgical treatment of oral cancer during an international multicenter rehabilitation study of the German-Swiss-Austrian Cooperative Working Group on Maxillofacial Tumors using a questionnaire comprising disease-related and psychosocial items postoperatively and at least 6 months after surgery. Results Only 35.4% of patients participated in rehabilitation. Age (p<0.001), sex (p<0.001), and marital status (p<0.05) significantly influenced participation in rehabilitation. Postoperative impairment (p<0.05) as well as quality of life (p<0.01) were significantly worse in patients who participated in rehabilitation. Nevertheless, this group of patients returned to work significantly more often, although later, than those who did not participate in rehabilitation (p<0.05). Conclusions The findings show social inequalities and suggest a general undersupply of rehabilitative follow-up treatment in patients with oral cancer. More patients, especially older people and women should be referred to rehabilitation.
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Affiliation(s)
- Philippe Korn
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany,*To whom correspondence should be addressed: Philippe Korn, Department of Oral and Maxillofacial Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany, Phone: +49 (0)511 532 4752, Fax: +49 (0)511 532 4740, E-mail:
| | - Simon Spalthoff
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany
| | - Joachim Hammersen
- Department of Otorhinolaryngology, Head, Neck & Plastic Facial Surgery, Klinikum Bad Hersfeld, Germany
| | | | - Frank Tavassol
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany
| | - Jan Winterboer
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany
| | - Fritjof Lentge
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany
| | - Nils-Claudius Gellrich
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany
| | - Philipp Jehn
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany
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Evaluation of Malnutrition and Quality of Life in Patients Treated for Oral and Oropharyngeal Cancer. ScientificWorldJournal 2021; 2021:9936715. [PMID: 34381320 PMCID: PMC8352700 DOI: 10.1155/2021/9936715] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 07/28/2021] [Indexed: 11/18/2022] Open
Abstract
Background Oral and oropharyngeal cancer is a debilitating disease with high morbidity and mortality. Depending on the site and extent of the involvement of the cancer and the type of treatment modality, these patients can develop pain, trismus, xerostomia, dysphagia, and taste disturbances, compromising them socially and nutritionally. The aim of the study was to evaluate malnutrition and quality of life in patients treated for oral and oropharyngeal cancer. Methodology. A cross-sectional study was conducted which included 97 patients treated for oral and oropharyngeal cancer. The quality of life of the selected patients was assessed by using a validated European Organization for the Research and Treatment of Cancer's Quality of Life Questionnaire, Head and Neck and Mandibular Function Impairment Questionnaire. Pre- and posttreatment weight of the patients were assessed, and weight loss of ≥10% of pretreatment weight was considered as malnutrition. The chi-square test was used to correlate the symptoms with the quality of life. A paired t test was used to assess the differences in weight before and after treatment, and a p value of <0.005 was considered as significant. Results The most commonly reported symptoms were xerostomia (93.81%), pain (81.44%), and dysphagia (76.3%). A total of 40.2% of the individuals in the study had malnutrition. Malnutrition was comparatively lower in the group who had nutritional supplements. Conclusion The quality of life in patients treated for oral and oropharyngeal cancer deteriorates immediately after the treatment; however, it significantly improves over time.
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Hasegawa T, Yatagai N, Furukawa T, Wakui E, Saito I, Takeda D, Kakei Y, Sakakibara A, Nibu KI, Akashi M. The prospective evaluation and risk factors of dysphagia after surgery in patients with oral cancer. J Otolaryngol Head Neck Surg 2021; 50:4. [PMID: 33494830 PMCID: PMC7830751 DOI: 10.1186/s40463-020-00479-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 11/16/2020] [Indexed: 11/10/2022] Open
Abstract
Background This prospective study investigated the change of swallowing ability using the Swallowing Ability Scale System (SASS) and swallowing-related quality of life (QOL) by Performance Status Scale for Head and Neck Cancer patients (PSS-H&N). This study also investigated the risk factors for postoperative dysphagia in patients who received reconstructive surgery for oral cancer. Subjects and Methods This study included 64 patients (33 men and 31 women) who underwent radical surgery with neck dissection and reconstructive surgery for oral cancers between July 2014 and February 2018. We evaluated risk factors for poor swallowing ability after treatment, including demographic factors, preoperative factors and perioperative factors, with univariate and multivariate analyses. The change of swallowing ability by the SASS and swallowing-related QOL by PSS-H&N were evaluated prospectively prior to the initiation of surgery within 1 week and at 1 and 3 months after treatment. Results Advanced T stage (T3, 4) (odds ratio (OR) = 79.71), bilateral neck dissection (OR = 20.66) and the resection of unilateral or bilateral suprahyoid muscles (OR = 17.00) were associated with poor swallowing ability after treatment. The scores for time for food intake and Eating in Public were associated with decrease of QOL in the poor group. Conclusions We propose that clinicians consider the risk factors identified in this study and pay close attention to the management of oral cancer patients with reconstructive surgery. Graphical abstract ![]()
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Affiliation(s)
- Takumi Hasegawa
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
| | - Nanae Yatagai
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Tatsuya Furukawa
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Emi Wakui
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Izumi Saito
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Daisuke Takeda
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Yasumasa Kakei
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Akiko Sakakibara
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Ken-Ichi Nibu
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masaya Akashi
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
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Wang JR, Nurgalieva Z, Fu S, Tam S, Zhao H, Giordano SH, Hutcheson KA, Lewis CM. Utilization of rehabilitation services in patients with head and neck cancer in the United States: A SEER-Medicare analysis. Head Neck 2019; 41:3299-3308. [PMID: 31240808 DOI: 10.1002/hed.25844] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Revised: 05/17/2019] [Accepted: 06/04/2019] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Head and neck cancer (HNC) and its treatment lead to functional impairments. Rehabilitation by speech-language pathology (SLP) and occupational/physical therapy (OT/PT) can decrease morbidity. METHODS The Surveillance, Epidemiology and End Results-Medicare data for patients with HNC diagnosed between 2002 and 2011 was utilized to evaluate posttreatment rehabilitation. RESULTS In 16 194 patients, the overall utilization rate was 20.7% for SLP and 26.2% for OT/PT services. Treatment modality was significantly associated rehabilitation utilization. Compared to patients treated with primary surgery, those treated with primary radiotherapy had significantly lower odds of OT/PT utilization. Patients treated with surgery plus adjuvant treatment and primary concurrent chemoradiation had higher odds of SLP utilization compared to patients treated with surgery alone. CONCLUSIONS Rehabilitation services appeared to be underutilized by patients with HNC in the United States and vary with treatment modality. There is a need to improve integration of rehabilitation services into the HNC care continuum. SUMMARY Rehabilitation services are underutilized by patients with HNC during posttreatment surveillance in the United States. Treatment modality significantly impacts rehabilitation utilization patterns.
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Affiliation(s)
- Jennifer R Wang
- Department of Head and Neck Surgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Zhannat Nurgalieva
- Department of Head and Neck Surgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Shuangshuang Fu
- Department of Health Services Research, Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Samantha Tam
- Department of Head and Neck Surgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Hui Zhao
- Department of Health Services Research, Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Sharon H Giordano
- Department of Health Services Research, Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Katherine A Hutcheson
- Department of Head and Neck Surgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Carol M Lewis
- Department of Head and Neck Surgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
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Alcázar Sánchez-Elvira L, Bacian Martínez S, Del Toro Gil L, Gómez Tello V. Postoperative management in the Intensive Care Unit of head and neck surgery patients. Med Intensiva 2019; 44:46-53. [PMID: 31174894 DOI: 10.1016/j.medin.2019.05.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 04/30/2019] [Accepted: 05/03/2019] [Indexed: 01/26/2023]
Abstract
Patient care after major head and neck surgery has changed in recent years. Tumors are the most common reasons for this type of surgery, though it is also used to treat benign conditions. Recent advances in equipment and surgical techniques have improved the postoperative course in this field, allowing early recovery, less pain and infection, a shorter hospital stay, and even better aesthetic results. This is due to the use of minimally invasive techniques, which are gaining relevance. Such techniques allow complex procedures in the head and neck region, through natural orifices or small incisions, with minimal damage and sequelae for the patients. Despite these advances, however, the complexity of the treatment intervention requires multidisciplinary patient management, mostly in the Intensive Care Unit, in order to monitor the possible occurrence of complications. Potential risk factors include previous comorbidity, the type of surgery involved (e.g., bilateral cervical lymphadenectomy), multiple transfusions, and the appearance of early complications requiring repeat surgery. Despite the existence of several studies, there are no standardized protocols for the postoperative period in surgeries of this kind. This causes many specialists to resort to accelerated recovery protocols (ERAS: "Enhanced Recovery After Surgery") that have already been established in other surgical specialties.
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Affiliation(s)
| | - S Bacian Martínez
- Departamento de Cirugía Máxilofacial,Hospital HLA Universitario Moncloa, Madrid, España
| | - L Del Toro Gil
- Departamento de Otorrinolaringología,Hospital HLA Universitario Moncloa, Madrid, España
| | - V Gómez Tello
- Departamento de Medicina Intensiva, Hospital HLA Universitario Moncloa, Madrid, España; Servicio de Urgencias, Hospital HLA Universitario Moncloa, Madrid, España; Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, España
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Davidson A, Williams J. Factors affecting quality of life in patients experiencing facial disfigurement due to surgery for head and neck cancer. ACTA ACUST UNITED AC 2019; 28:180-184. [DOI: 10.12968/bjon.2019.28.3.180] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Anna Davidson
- PG Diploma Student Nurse (Adult), Bucks New University, Uxbridge
| | - Julia Williams
- Senior Lecturer (Adult), PG Dip Programme Lead, Bucks New University, Uxbridge
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Abbas S, Tariq MUU, Raheem A, Saeed J, Hashmi SS, Karim M, Nizam M. Assessment of Factors Affecting Quality of Life in Oral Squamous Cell Carcinoma Patients Using University of Washington Quality of Life Questionnaire. Cureus 2019; 11:e3904. [PMID: 30911459 PMCID: PMC6424547 DOI: 10.7759/cureus.3904] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Introduction Post-treatment Quality of Life (QOL) is considered an important outcome in cancer patients. A number of questionnaire tools have been designed for its assessment. University of Washington Quality of Life (UW QOL) questionnaire version four is a reliable tool for assessment of post-treatment QOL in oral squamous cell carcinoma (OSCC) patients. Our aim was to identify the post-treatment problems faced by OSCC patients and to assess the impact of clinical factors affecting post-treatment QOL by using UW QOL (version four) questionnaire. Methods The study was conducted on 59 patients with OSCC who were treated with curative intent at Patel Hospital, Karachi from August 2015 to September 2015. Patients were asked to fill the UW QOL questionnaire (version four) on their follow-up visit. Results Overall mean composite QOL score was 66.59 ± 16.98. Chewing and saliva (dryness of mouth) had the lowest scores (38.98 ± 37.2 and 56.78 ± 41.4, respectively) among all domains while pain and anxiety had the highest scores (80.93 ± 20.4 and 79.66 ± 29.8, respectively). Patients having tumors of the tongue, late stage (III and IV) tumors, and restricted mouth opening had significantly lower mean composite QOL scores. Patients with tongue tumors revealed significantly lower scores for pain, swallowing, mood, and anxiety. Patients with late-stage tumors showed significantly lower scores for chewing, swallowing, taste, saliva, appearance, anxiety, and recreation. Patients with restricted mouth opening had significantly lower scores for pain, speech, appearance, recreation, and anxiety domains. Conclusion Different clinical features have different impacts on QOL in terms of problems faced by the patients. Features having a significant effect should be identified, and measures focused on most relevant problems should be employed in order to improve the post-treatment QOL.
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Affiliation(s)
- Syed Abbas
- Otolaryngology, Aga Khan University Hospital, Karachi, PAK
| | | | - Ahmed Raheem
- Pathology, Aga Khan University Hospital, Karachi, PAK
| | | | - Syed S Hashmi
- Otolaryngology, Baqai Medical University, Karachi, PAK
| | - Musa Karim
- Miscellaneous, National Institute of Cardiovascular Diseases, Karachi, PAK
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Surgical versus medical treatment for ocular surface squamous neoplasia: A quality of life comparison. Ocul Surf 2018; 17:60-63. [PMID: 30217629 DOI: 10.1016/j.jtos.2018.09.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Revised: 07/08/2018] [Accepted: 09/06/2018] [Indexed: 11/21/2022]
Abstract
PURPOSE To characterize vision-related and psychosocial quality of life (QoL) parameters in medically and surgically treated patients with OSSN. METHODS Forty-one patients with OSSN treated with medical therapy consisting of interferon alpha 2b drops 1 MIU/ml (n = 22) or who underwent surgical excision (n = 19) were contacted. All subjects answered a quality of life assessment with an original questionnaire in which they were asked about a range of parameters. Overall satisfaction and motivating factors for treatment were also reviewed. RESULTS The mean age at the time of the survey was 64.6 and 51% were male with similar demographics between groups. Based on the previous cohort, rates of tumor resolution and recurrences were comparable in the two groups. Reasons for choosing a particular treatment varied between the groups. Forty percent of individuals in the medical group reported a fear of surgery (p = 0.03) and often made the decision after personal research (p = 0.008). Thirty-two percent of patients in the surgical group chose surgery due to fear of decreased vision due to lesion growth, therefore wanting immediate resolution (p = 0.09). Drops precipitated more ocular symptoms such as tearing and itchiness, on the other hand, patients who had surgery reported having more pain. CONCLUSION Quality of life considerations before, during, and after OSSN treatment is an important yet understudied topic. Our study is the first to look at QoL parameters in OSSN treatment and we found that patients in both medically and surgically treated groups had similar QoL metric but were driven to choose chemotherapy due to fear of surgery and/or prior literature review.
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Sharaf MY, Ibrahim SI, Eskander AE, Shaker AF. Prosthetic versus surgical rehabilitation in patients with maxillary defect regarding the quality of life: systematic review. Oral Maxillofac Surg 2018; 22:1-11. [PMID: 29388055 DOI: 10.1007/s10006-018-0679-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 01/09/2018] [Indexed: 11/29/2022]
Abstract
PURPOSE To assess the ability of prosthetic rehabilitation versus surgical rehabilitation in improving the QOL for patients with maxillary defects. MATERIAL AND METHODS A systematic search of PubMed, Scopus data base, Cochrane database, Ovid database, and Latin America & Caribbean database for articles published before September 2017 was performed by two independent reviewers. A manual search of articles published from January 2000 to September 2017 was also conducted. Only English studies were included which evaluate the QoL in patients with head and neck cancers. Any confusion between the two independent reviewers was resolved by means of a moderated discussion between the reviewers. RESULTS Five studies fulfilled the inclusion criteria for this study. Many parameters were used regarding evaluation of QOL as the EORTC Head and Neck 35 assessment, UW-QOL, OHIP-14, VAS, OFS, MHI, HAD, Body Satisfaction Scale, Oral symptom check list, Swallowing, Diet consist, Pain control, Postoperative complication, and Speech. Two studies supported the surgical line of treatment for improving the QOL as compared to the prosthetic one; another two studies showed a statistically insignificant improvement in the patients' QOL with the surgical line, while only one revealed insignificant difference in QoL with both lines of treatment. CONCLUSIONS Surgical rehabilitation provides a better line of treatment in improving the QOL for patients with maxillary defects. On the other hand, prosthetic has proved effectiveness in the immediate post-surgical times as temporary strategy, and it has represented a good alternative when the surgical obturation is compromised.
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Affiliation(s)
- M Y Sharaf
- Department of Prosthodontics, Faculty of Dentistry, University of Beni-Suef, Beni-Suef, 62511, Egypt.
| | - S I Ibrahim
- Department of Prosthodontics, Faculty of Oral and Dental Medicine, University of Cairo, Cairo, Egypt
| | - A E Eskander
- Department of Prosthodontics, Faculty of Oral and Dental Medicine, University of Cairo, Cairo, Egypt
| | - A F Shaker
- Department of Prosthodontics, Faculty of Dentistry, University of Beni-Suef, Beni-Suef, 62511, Egypt
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Depta A, Jewczak M, Skura-Madziała A. Quality of life of patients from rural and urban areas in Poland with head and neck cancer treated with radiotherapy. A study of the influence of selected socio-demographic factors. Arch Med Sci 2017; 13:1474-1482. [PMID: 29181080 PMCID: PMC5701701 DOI: 10.5114/aoms.2017.71068] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 11/28/2015] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION The quality of life (QoL) experienced by cancer patients depends both on their state of health and on sociodemographic factors. Tumours in the head and neck region have a particularly adverse effect on patients psychologically and on their social functioning. MATERIAL AND METHODS The study involved 121 patients receiving radiotherapy treatment for head and neck cancers. They included 72 urban and 49 rural residents. QoL was assessed using the questionnaires EORTC-QLQ-C30 and QLQ-H&N35. The data were analysed using statistical methods: a χ2 test for independence and a multinomial logit model. RESULTS The evaluation of QoL showed a strong, statistically significant, positive dependence on state of health, and a weak dependence on sociodemographic factors and place of residence. Evaluations of financial situation and living conditions were similar for rural and urban residents. Patients from urban areas had the greatest anxiety about deterioration of their state of health. Rural respondents were more often anxious about a worsening of their financial situation, and expressed a fear of loneliness. CONCLUSIONS Studying the QoL of patients with head and neck cancer provides information concerning the areas in which the disease inhibits their lives, and the extent to which it does so. It indicates conditions for the adaptation of treatment and care methods in the healthcare system which might improve the QoL of such patients. A multinomial logit model identifies the factors determining the patients' health assessment and defines the probable values of such assessment.
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Affiliation(s)
- Adam Depta
- Department of Health Care Financing, Medical University of Lodz, Lodz, Poland
- Department of Management, Technical University of Lodz, Lodz, Poland
| | - Maciej Jewczak
- Department of Spatial Econometrics, Institute of Spatial Economics, Faculty of Economics, and Sociology, University of Lodz, Lodz, Poland
| | - Anna Skura-Madziała
- Institute of Public Health, Collegium Masoviensae, Lodz, Poland
- Regional Oncological Centre, Radiotherapy and General Oncology Ward, Nicolaus Copernicus Hospital, Lodz, Poland
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Breen LJ, O'Connor M, Calder S, Tai V, Cartwright J, Beilby JM. The health professionals' perspectives of support needs of adult head and neck cancer survivors and their families: a Delphi study. Support Care Cancer 2017; 25:2413-2420. [PMID: 28258504 DOI: 10.1007/s00520-017-3647-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2016] [Accepted: 02/17/2017] [Indexed: 10/20/2022]
Abstract
PURPOSE The aim was to identify the views of Australian and New Zealand health professionals regarding the support needs of people with head and neck cancer (HNC) and their families and current gaps in service delivery. METHODS A modified Delphi process assessed support needs of people with HNC following acute medical management. A systematic review of the literature was used to develop items relevant to seven key concepts underpinning the psychological experience of living with HNC. A panel of 105 health professionals was invited to participate in two questionnaire rounds. RESULTS Of the potential panellists, 50 (48%) completed round 1, and of these, 39 (78%) completed round 2. Following two rounds, there was consensus agreement on the concepts uncertainty and waiting, disruption to daily life and fear of recurrence. The concepts the diminished self, making sense of and managing the experience, sharing the burden and finding a path did not achieve consensus. There were no differences in responses according to gender, organization type or location. Medical professionals had significantly higher agreement for the concept uncertainty and waiting compared to allied health professionals, and professionals with five years' or more experience had significantly higher agreement than those with less experience. CONCLUSIONS Health professionals agreed that many psychosocial support needs of HNC survivors and families are not being met and that they experience difficulties in meeting these needs. Findings may inform evidence-based treatment programs for HNC survivors and their families to promote psychological resilience and quality of life in this vulnerable population.
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Affiliation(s)
- Lauren J Breen
- School of Psychology and Speech Pathology, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia.
| | - Moira O'Connor
- School of Psychology and Speech Pathology, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia
| | - Samuel Calder
- School of Psychology and Speech Pathology, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia
| | - Vivian Tai
- School of Psychology and Speech Pathology, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia
| | - Jade Cartwright
- School of Psychology and Speech Pathology, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia.,Centre for Neuroscience of Speech, University of Melbourne, Melbourne, Australia
| | - Janet M Beilby
- School of Psychology and Speech Pathology, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia
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14
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Petrosyan V, Ball D, Harrison R, Ameerally P. Among Patients Undergoing Ablative Treatment for Oral Cancer, Does the Provision of Oral Rehabilitation Improve the Quality of Life? A Review of the Current Literature. J Oral Maxillofac Surg 2016; 74:1096.e1-1096.e12. [PMID: 26824305 DOI: 10.1016/j.joms.2015.12.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 12/11/2015] [Accepted: 12/16/2015] [Indexed: 11/24/2022]
Abstract
PURPOSE The impact of oral cancer and its treatment is well documented; therefore, oral rehabilitation (OH; eg, with prosthetics, osseointegrated implants, etc) can be indicated to restore some level of form, function, and well-being. The purpose of this study was to review the current literature and evaluate the impact of OH on quality of life (QoL) after ablative surgery. MATERIALS AND METHODS A systematic literature search was conducted using EMBASE, MEDLINE, and PsychINFO. The study population was composed of all articles published from 2000 to 2015. To be included, studies had to use validated, specific head and neck QoL measurements (European Organization for Research and Treatment of Cancer QoL Head and Neck Module or University of Washington QoL Questionnaire). Only 8 articles met these inclusion criteria. In this review, OH was the primary predictor variable and QoL was the primary outcome variable. RESULTS The 8 articles reviewed used a range of designs, including 1 randomized controlled trial, 3 prospective cohort studies, 3 case series, and 1 single-measurement cross-sectional descriptive study. Sample sizes were small (n = 26 to 102), and there was limited randomization and control of intervention and comparator groups. The overall level of evidence was weak. All studies showed a link between OH and QoL, but the results varied in significance (P < .01 to P = .95). CONCLUSION Overall, there appears to be improvement in QoL to varying degrees after OH. However, a more systematic use of QoL measurements is needed before any definitive conclusions can be drawn.
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Affiliation(s)
- Vahe Petrosyan
- Staff Grade in Oral and Maxillofacial Surgery, Northampton General Hospital, Northampton; Medical Student, University of Birmingham, Birmingham, UK.
| | - Dimity Ball
- Medical Student, University of Birmingham, Birmingham, UK
| | | | - Phillip Ameerally
- Consultant in Oral and Maxillofacial Surgery, Northampton General Hospital, Northampton, UK
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15
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Vijayaraghavan NV, Ramesh G, Thareja A, Patil S. Masticatory efficiency after rehabilitation of acquired maxillary and mandibular defects. Indian J Dent 2015; 6:139-46. [PMID: 26392731 PMCID: PMC4558749 DOI: 10.4103/0975-962x.155880] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The effect of oral cancer with its therapeutic intervention involves significant facial and functional disabilities. It is customary to rehabilitate these patients by surgical or prosthetic means. Studies have been done to assess mastication and other functions after rehabilitation. A review of these studies for assessing masticatory function has been done under separate sections for maxillary and mandibular defects. Different masticatory tests are mentioned. Further scope for research has been highlighted.
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Affiliation(s)
| | - Ganesh Ramesh
- Department of Prosthodontics, Sree Balaji Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Amit Thareja
- Department of Prosthodontics, Bharati Vidyapeeth Dental College, Pune, Maharashtra, India
| | - Seema Patil
- Department of Prosthodontics, Bharati Vidyapeeth Dental College, Pune, Maharashtra, India
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16
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Seignemartin CP, Miranda ME, Luz JGC, Teixeira RG. Understandability of Speech Predicts Quality of Life Among Maxillectomy Patients Restored With Obturator Prosthesis. J Oral Maxillofac Surg 2015; 73:2040-8. [PMID: 26003777 DOI: 10.1016/j.joms.2015.04.031] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2014] [Revised: 04/20/2015] [Accepted: 04/21/2015] [Indexed: 01/22/2023]
Abstract
PURPOSE Maxillary malignant tumor resection by maxillectomy might lead to defects that can be repaired by prosthetic obturation. The aim of this study was to associate quality of life (QoL) and the Obturator Functioning Scale (OFS) with functional performance and salivary flow rate in Brazilian patients rehabilitated with an obturator prosthesis. PATIENTS AND METHODS This retrospective cross-sectional study included patients who underwent surgical resection with or without radiotherapy or without chemotherapy and the rehabilitation with an obturator prosthesis at the Fundação Oncocentro de São Paulo (São Paulo, Brazil). The predictor variables were Performance Status Scale for Head and Neck Cancer Patients (PSS-HN) domains and clinical evaluation of salivary flow rate. The outcome variables were overall scores obtained by the University of Washington QoL Scale (UWQOL) and the OFS. Sociodemographics (gender and age) and clinical characteristics (postoperative radiotherapy, tumor stage, classification of maxillary defect, tooth in maxilla, and type of obturator) also were evaluated. Univariate and multivariate analyses were performed to determinate whether PSS-HN domains and salivary flow were predictors of overall QoL and overall OFS. RESULTS The sample was composed of 73 patients with a mean age of 62 years and 51% were men. According to the PSS-HN domains, some patients (5%) always ate alone, 87% reported that speech is usually or always understandable, and 56% had no dietary restrictions. Sixty-one patients (65%) reported some degree of hyposalivation. The mean overall QoL score was 76.5 (standard deviation, 5.3). Patients with compromised PSS-HN domains had significantly worse overall UWQOL scores (P = .001, P < .001, and P = .006, respectively). In multiple regression analyses, understandability of speech was the only predictor of overall QoL scores. CONCLUSION The results of this study showed that understandability of speech was the only predictor of overall QoL scores.
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Affiliation(s)
| | - Milton E Miranda
- Professor, Prosthodontic Department, School of Dentistry, São Leoplodo Mandic, Campinas, Brazil
| | - João Gualberto C Luz
- Full Professor, Department of Oral and Maxillofacial Surgery, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Rubens G Teixeira
- Professor, Department of Surgery and Traumatology, School of Dentistry, São Leopoldo Mandic, Campinas, Brazil
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17
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Development and preliminary evaluation of a rehabilitation consult for survivors of head and neck cancer: an intervention mapping protocol. Implement Sci 2015; 10:6. [PMID: 25571966 PMCID: PMC4297361 DOI: 10.1186/s13012-014-0191-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 12/10/2014] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Evidence suggests that rehabilitation interventions can improve function and quality of life in survivors of head and neck cancer (HNC), but there is a lack of coordinated, integrated services, and those offered are inconsistent. To address these gaps, we will develop and conduct preliminary evaluation of a rehabilitation consult, built on the theoretical foundations of goal setting and self-management, and composed of a brief functional evaluation, a resource compendium, and collaborative goal-setting and action planning processes. METHODS/DESIGN The development of the rehabilitation consult will be guided by intervention mapping, which consists of six steps: 1. Needs assessment; 2. Definition of program objectives; 3. Selection of theory-based intervention methods; 4. Production and pretesting; 5. Adoption, implementation and sustainability planning; 6. Process and effect evaluation. Within the intervention mapping framework, an iterative process of constructing drafts and mini-evaluations with consumers and experts will be used, modifying the rehabilitation consult intervention until a version suitable for formal evaluation is established. The rehabilitation consult will then be evaluated using a prospective, mixed method, single group design with 30 survivors of head and neck cancer. Outcomes will be assessed pre- and post-intervention and at 6-month follow-up. DISCUSSION Survivors of head and neck cancer have among the most complex rehabilitation needs of all cancer patients. The rehabilitation consult is expected to improve knowledge and uptake of rehabilitation resources and strategies in survivors of head and neck cancer and thereby improve long-term function and quality of life. If the rehabilitation consult is effective in cancer patients with such high and diverse needs, this project will produce a toolkit that will be adaptable for other types of cancer in other jurisdictions.
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