Objectives The purpose of the retrospective study was to compare the differences of quality of life (QOL) outcomes 2 or more years postoperatively between the free radial forearm flap (FRFF) and anterolateral thigh flap (ALTF) in reconstruction of defects of a hemiglossectomy. Methods Ninety patients who had a lapse ≥2 years since the reconstructive flap surgery were evaluated by the University of Washington quality of life scale (UW-QOL), and Performance Status Scale for Head and Neck (PSS-HN). Results Patients in the FRFF group reported statistically and clinically significantly better scores in the recreation, swallowing, chewing and speech domains of the UW-QOL compared with those in the ALTF group (P  Conclusions FRFF had the advantage of oral functions, such as chewing, speech and swallowing, over the ALTF for reconstruction of defect of half of the tongue. These results may provide useful information for surgeons to select a suitable free flap for tongue reconstruction.

Free radial forearm flap and anterolateral thigh flap for reconstruction of hemiglossectomy defects: A comparison of quality of life.

Oral cancer is the most common tumor of the head and neck region. Its management is based on surgical and systemic therapies. Taste disorders represent the most common side effect of these treatments; indeed, dysgeusia is noted by 70% of oral cancer patients. Despite survival remaining the primary endpoint of cancer patients, taste impairments can cause psychological distress. This comprehensive review describes the last decade’s knowledge from the literature regarding taste alterations in patients with oral and oropharyngeal squamous cell carcinoma. A total of 26 articles in English, including prospective, cross-sectional, and case–control studies, and clinical trials were evaluated. Literature analysis shows that anti-cancer treatments can destroy taste cells, decrease and alter their receptors, and interrupt nerve transmission. Furthermore, the tumour itself can destroy the oral mucosal lining, which encloses the taste buds. Dysgeusia typically occurs in 3–4 weeks of treatments, and usually taste sensation is recovered within 3–12 months. However, some patients exhibit incomplete or no recovery, even several years later. Thus, dysgeusia can become a chronic issue and negatively influence patients’ quality of life, worsening their dysphagia and their nutritional status. Physicians should be focused on preventing oncological treatment-related symptoms, offering the most suitable personalized support during therapy.

Treatment-Related Dysgeusia in Oral and Oropharyngeal Cancer: A Comprehensive Review.

Objective No published study has analyzed the prognostic factors of surgically treated oral squamous cell carcinoma (OSCC) in relation to both survival and quality of life (QoL). The aim of this study was to analyze postoperative QoL in relation to survival to identify which parameters can predict the long-term outcome allowing the best QoL. Study Design This retrospective cohort study considered 167 patients affected by OSCC treated surgically at the Otolaryngology Department of Cattinara Hospital (Trieste, Italy) by a single surgeon. We collected data about the main prognostic factors and the postoperative QoL 12 month after surgery. Results The 5-year overall survival rate was equal to 68.1%, and the 5-year disease-specific survival was 77.8%. In this sample, 32% of patients also underwent adjuvant chemoradiotherapy. On stepwise Cox regression, the best predictors of disease-specific survival were the N stage (P  Conclusion The prognostic factors that affect both survival rates and residual QoL are the surgical approach, the neck stage, and the depth of invasion, all of which can be minimized by early diagnosis.

Prognostic indicators of improved survival and quality of life in surgically treated oral cancer

Objectives The aim of this study was to investigate whether the direct damage of the articular fibrous layers without condylar fracture, combined with discectomy, was enough to induce temporomandibular joint (TMJ) ankylosis. Study Design Bilateral TMJ surgery was performed in 8 growing sheep. The lateral 2/3 of disc removal (DR) was performed on the control side, whereas the lateral 2/3 of disc and articular fibrous layers removal (DFLR) were performed on the experimental side. Four and 4 animals were sacrificed respectively at 1 and 3 months postoperatively. Results Fibrous ankylosis was achieved on the DFLR side of the 2 of 4 sheep, and fibro-osseous ankylosis in the other 2 sheep at 1 month after surgery. Fibro-osseous ankylosis developed on the DFLR side of 4 sheep at 3 months postoperatively. On the DR side of animals, pathological characteristics of TMJ osteoarthritis could be found, however no evidence of ankylosis was observed. The scores of TMJ ankylosis for the DR side were significantly lower than that of the DFLR side at different time points ( P Conclusion This study demonstrated that removal of articular fibrous layers combined with discectomy can lead to traumatic TMJ ankylosis.

Removal of the articular fibrous layers with discectomy leads to temporomandibular joint ankylosis.

Incidence of oral cancer have been increased aggressively in recent years, and many advanced surgical techniques have developed to facilitate the treatment of disease while preserving the patient’s quality of life (QoL). The present study aims toward the evaluation of patient’s satisfaction toward the current treatment procedure for oral cancer by assessing the QoL preoperatively and postoperatively. In the study period of four years, we had operated 150 patients with oral cancer (Stage III and IVa) by surgical excision and flap reconstruction, and QoL was assessed using the WHO-QoL BREF questionnaire.  We found significant improvement after surgery in various aspects of QoL including the physical health, social health, psychological health and environmental health. The present study is evidence of patient satisfaction toward the current treatment protocols  of oral cancer. However, advanced surgical techniques that can enhance the rate of functional rehabilitation can have paramount importance in improving the patient’s QoL.

Quality of Life in Oral Cancer Patients Following Surgical Excision and Flap Reconstruction

Preserving the Fibrous Layer of the Mandibular Condyle Reduces the Risk of Ankylosis in a Sheep Model of Intracapsular Condylar Fracture.

Background The purpose of the study was to compare the differences of the subjective satisfaction of the donor site morbidity between the free radial forearm flap (FRFF) and anterolateral thigh flap (ALTF) for tongue reconstruction. Material and methods One hundred and nineteen patients underwent FRFF or ALTF reconstruction were retrospectively evaluated by a standardized self-established donor site morbidity questionnaire which included 5 domains, sensibility, movement disabilities, cosmetics, social activities and general impacts on the quality of life. Results The Cronbach's coefficient alpha of the questionnaire was 0.707. The exploratory factor analysis revealed that the 5 items of the questionnaire might load onto two distinct subscales. Patients with ALTF had higher scores in the sensibility, cosmetics and the composite score (P 0.05). Conclusions ALTF has the advantage of better results of donor site morbidity, such as sensibility and cosmetics, over FRFF.

/pdf/comparison-of-the-subjective-satisfaction-of-the-donor-site-b8dq9gatx2.pdf

Comparison of the subjective satisfaction of the donor site morbidity: Free radial forearm flap versus anterolateral thigh flap for reconstruction in tongue cancer patients.

Objectives The purpose of the prospective study was to evaluate the long-term changes in quality of life (QOL) in patients with oral cancer and to examine the potential factors that predicted QOL at 8 years after treatment. Study Design Seventy-one patients were evaluated by the University of Washington quality of life scale. QOL in 30 long-term survivors was assessed at diagnosis and at the 3-month, 1-year, and 8-year follow-up. Results QOL was found to be better among survivors compared with nonsurvivors at the 1-year follow-up. Levels of pain, mood, and anxiety showed clinically and statistically significant improvements between diagnosis and at 8 years following treatment, whereas problems with chewing, speech, shoulder mobility, and taste worsened during this interval (P  Conclusions Although the QOL among patients with oral cancer was generally favorable in the long term, the changed patterns in different domains over time should be noted. Improved QOL between the 1-year and the 8-year follow-up demonstrated the dynamics of QOL after 1 year and justified ongoing follow-up beyond the 1-year observation point.

Quality of life in long-term oral cancer survivors: an 8-year prospective study in China.

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Removal of the articular fibrous layers with discectomy leads to temporomandibular joint ankylosis.

Preserving the Fibrous Layer of the Mandibular Condyle Reduces the Risk of Ankylosis in a Sheep Model of Intracapsular Condylar Fracture.

Comparison of the subjective satisfaction of the donor site morbidity: Free radial forearm flap versus anterolateral thigh flap for reconstruction in tongue cancer patients.

Quality of life in long-term oral cancer survivors: an 8-year prospective study in China.