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Qayyum Z, Khan ZA, Maqsood A, Prabhu N, Saad Alqarni M, Bader AK, Issrani R, Abbasi MS, Ahmed N, Sghaireen MG, Heboyan A. Outcome Assessment after Reconstruction of Tumor-Related Mandibular Defects Using Free Vascularized Fibular Flap-A Clinical Study. Healthcare (Basel) 2023; 11:healthcare11020193. [PMID: 36673561 PMCID: PMC9859578 DOI: 10.3390/healthcare11020193] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/31/2022] [Accepted: 01/04/2023] [Indexed: 01/11/2023] Open
Abstract
The objective of this study was to analyze the outcomes of the free vascularized fibular flap in the reconstruction of mandibular defects, and to assess the oral health impact profile of these patients before surgery and after oral rehabilitation. Patients requiring reconstruction of defects greater than 6 cm were selected for this study. The defect size and type, the size of the required skin paddle, the need for second flaps, the intraoperative complications, and the type of closure were documented. Patients were evaluated postoperatively for function, aesthetics, and donor- or reconstruction-site complications. The validated oral health impact profile (OHIP-14) questionnaires were filled before and after surgery and after dental rehabilitation. This study included 11 cases of squamous-cell carcinomas, 2 cases of malignant nerve sheath tumors, and 1 case each of malignant melanoma, ameloblastoma, giant-cell tumor, osteosarcoma, and chondrosarcoma. The analysis revealed a significant association (p = 0.030) of gender with free vascular flap complications, while no significant association (p > 0.05) was found when donor- and recipient- site complications, as well as the type of resection (Brown’s classification), were compared with free vascular flaps. Moreover, the total OHIP-14 scores for patients before surgery, after surgery, and after dental rehabilitation were 12.03 ± 1.34, 10.66 ± 1.41, and 08.33 ± 0.62, respectively. The oral health-related quality of life was markedly improved after the reconstruction of the mandibular defects with free vascularized fibular flap and dental rehabilitation. The overall success rate of fibular flap in our study was 72.2%, which is lower than that reported in the literature. This may be attributed to the fact that almost all of our cases included large segmental defects that extended across the midline of the mandible.
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Affiliation(s)
- Zahid Qayyum
- Department of Oral & Maxillofacial Surgery, Khyber Girls Medical College, Hayatabad Medical Complex, Peshawar 23301, Pakistan
| | - Zafar Ali Khan
- Department of Oral & Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jouf University, Sakaka 72388, Saudi Arabia
| | - Afsheen Maqsood
- Department of Oral Pathology, Bahria University Dental College, Karachi 75530, Pakistan
| | - Namdeo Prabhu
- Department of Oral & Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jouf University, Sakaka 72388, Saudi Arabia
| | - Mohammed Saad Alqarni
- Department of Oral & Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jouf University, Sakaka 72388, Saudi Arabia
| | - Alzarea K. Bader
- Department of Prosthetic Dental Sciences, College of Dentistry, Jouf University, Sakaka 72388, Saudi Arabia
| | - Rakhi Issrani
- Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka 72388, Saudi Arabia
| | - Maria Shakoor Abbasi
- Department of Prosthodontics, Altamash Institute of Dental Medicine, Karachi 75500, Pakistan
| | - Naseer Ahmed
- Department of Prosthodontics, Altamash Institute of Dental Medicine, Karachi 75500, Pakistan
- Correspondence: (N.A.); (A.H.)
| | - Mohammed Ghazi Sghaireen
- Department of Prosthetic Dental Sciences, College of Dentistry, Jouf University, Sakaka 72388, Saudi Arabia
| | - Artak Heboyan
- Department of Prosthodontics, Faculty of Stomatology, Yerevan State Medical University after Mkhitar Heratsi, Str. Koryun 2, Yerevan 0025, Armenia
- Correspondence: (N.A.); (A.H.)
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Caruntu A, Scheau C, Codrici E, Popescu ID, Calenic B, Caruntu C, Tanase C. The Assessment of Serum Cytokines in Oral Squamous Cell Carcinoma Patients: An Observational Prospective Controlled Study. J Clin Med 2022; 11:jcm11185398. [PMID: 36143043 PMCID: PMC9503270 DOI: 10.3390/jcm11185398] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/28/2022] [Accepted: 09/12/2022] [Indexed: 11/16/2022] Open
Abstract
Background: The oral squamous cell carcinoma (OSCC) tumor microenvironment (TME) is a complex interweb of cells and mediators balancing carcinogenesis, inflammation, and the immune response. However, cytokines are not only secreted within the TME but also released by a variety of other cells that do not comprise the TME; therefore, a thorough assessment of humoral changes in OSCC should include the measurement of serum cytokines. Methods: We assessed the role of various serum cytokines in the evolution of OSCC, before and after treatment, versus a control group. We measured the serum concentrations of MIP-1α, IL-1β, IL-4, IL-6, IL-8, IL-10, and TNF-α. Results: Significantly higher values (p < 0.01) were noted for IL-1β, IL-6, IL-8, IL-10, and TNF-α in the OSCC group before treatment (n = 13) compared with the control group (n = 14), and the increased concentrations persisted after treatment (n = 11). Furthermore, the variations in the values of MIP-1α, IL-1β, IL-10, and TNF-α are correlated both before and after treatment (p < 0.01). In the pretherapeutic group, IL-6 and IL-8 concentrations also correlate with IL-1β and IL-10 serum levels (p < 0.01), while in the posttherapeutic group, IL-4 varies with MIP-1α and TNF-α (p < 0.01). Conclusion: In OSCC patients, serum cytokine levels are significantly higher compared with control, but they are not significantly altered by treatment, therefore implying that they are also influenced by systemic factors. The interactions between all involved cytokines and the various pathways they regulate warrant further studies to clarify their definitive roles.
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Affiliation(s)
- Ana Caruntu
- Department of Oral and Maxillofacial Surgery, "Carol Davila" Central Military Emergency Hospital, 010825 Bucharest, Romania
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, "Titu Maiorescu" University, 031593 Bucharest, Romania
| | - Cristian Scheau
- Department of Physiology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Elena Codrici
- Biochemistry-Proteomic Laboratory, Victor Babes National Institute of Pathology, 050096 Bucharest, Romania
| | - Ionela Daniela Popescu
- Biochemistry-Proteomic Laboratory, Victor Babes National Institute of Pathology, 050096 Bucharest, Romania
| | - Bogdan Calenic
- Centre for Immunogenetics and Virology, Fundeni Clinical Institute, Carol Davila University of Medicine and Pharmacy, 258 Fundeni Road, 022328 Bucharest, Romania
| | - Constantin Caruntu
- Department of Physiology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Dermatology, Prof. N.C. Paulescu National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest, Romania
| | - Cristiana Tanase
- Biochemistry-Proteomic Laboratory, Victor Babes National Institute of Pathology, 050096 Bucharest, Romania
- Department of Molecular Biology, Faculty of Medicine, "Titu Maiorescu" University, 031593 Bucharest, Romania
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