Abstract
BackgroundThe reconstruction of mandibular defects after trauma or tumor resection is one of the most challenging problems facing reconstructive surgeons. Although the primary intended outcome of surgery to treat head-and-neck malignancies is still the disease-free survival of the patient, health-related quality of life (HRQOL) is now seen as an essential secondary outcome. This study aims to evaluate HRQOL outcomes in young patients undergoing primary mandible reconstruction with free fibula flap and to collect information about their socio-cultural situation.MethodsThe HRQOL outcomes of 25 young patients after primary mandible reconstruction with free fibula flap for mandible malignancies were assessed using the Medical Outcomes Study-Short Form-36 (MOS SF-36) and University of Washington Quality of Life (UW-QOL) questionnaires 12 months postoperatively.ResultsUsing the UW-QOL questionnaire, the best-scoring domain was ‘pain’, whereas ‘chewing’ and ‘anxiety’ were given the lowest scores. Using the MOS SF-36 questionnaire, the best-scoring domain was ‘physical functioning’, while ‘bodily pain’ and ‘general health’ also scored well.ConclusionsMandible reconstruction with fibula flap will significantly influence a young patient’s HRQOL. Young patients pay more attention to postoperative facial appearance; this should be considered in surgical planning. The socio-cultural data show a fairly low level of education for the majority of patients.
Highlights
The reconstruction of mandibular defects after trauma or tumor resection is one of the most challenging problems facing reconstructive surgeons
In 1989, Hidalgo reported a significant series of free fibula flaps for mandibular reconstruction [4]
Patients were eligible for inclusion if they had had free fibula flap reconstructive surgery with complete survival at least 12 months previously, were aged between 18 and 45 years, had no previous or synchronous malignancies, had no cognitive impairment
Summary
The reconstruction of mandibular defects after trauma or tumor resection is one of the most challenging problems facing reconstructive surgeons. This study aims to evaluate HRQOL outcomes in young patients undergoing primary mandible reconstruction with free fibula flap and to collect information about their socio-cultural situation. Free vascularized fibula and soft tissue transfer is a widely described method of reconstruction of the mandibular defects, when managing oncologic patients [1,2]. In 1989, Hidalgo reported a significant series of free fibula flaps for mandibular reconstruction [4]. The free vascularized fibula flap provides the longest segment of bone, with 20 to 30 cm available for harvest. This flap can be used to span an angle-to-angle defect
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