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Long‐term functional and esthetic outcomes after fibula free flap reconstruction of the mandible
Author(s) -
Petrovic Ivana,
Baser Raymond,
Blackwell Timothy,
McCarthy Colleen,
Ganly Ian,
Patel Snehal,
Cordeiro Peter,
Shah Jatin
Publication year - 2019
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.25666
Subject(s) - trismus , medicine , dentistry , mandible (arthropod mouthpart) , dentition , fibula , malocclusion , free flap , head and neck cancer , orthodontics , radiation therapy , surgery , tibia , botany , biology , genus
Background The goal of this study is to report functional and esthetic outcomes, after fibula free flap (FFF) reconstruction of the mandible for oral cancer, assessed by physicians, nonclinicians, and patients. Methods Twenty‐five long‐term survivors from oral cancer after FFF reconstruction were recalled for head and neck examination by surgeons, for photographs and patient‐reported outcomes, using EORTC, QLQ‐C30, H&N35, and FACE‐Q questionnaires. Results Physicians reported 64% restoration of functionality compared to normal. Patients reported high scores on QLQ‐C30 but lower scores on H&N35. Esthetic scores were reported higher by clinicians than nonclinicians. The decline in function and appearance was attributed to loss of lower dentition, trismus, malocclusion, xerostomia, and tissue atrophy. Conclusion To minimize the decline in function and appearance, immediate dental implants in FFF, better reconstruction of the temporomandibular joint, newer methods of radiotherapy to minimize xerostomia and oral exercises to prevent trismus should be considered.