UW-QOL Questionnaire Research Articles

Radial forearm flap versus antero-lateral thigh flap in oral soft tissue reconstruction: update and statistical analysis on our 77 consecutive cases for an objective selection criteria.

The radial forearm free flap (RFFf) and the antero-lateral thigh flap (ALTf) are considered the "key flaps" for oral cavity reconstruction. Nowadays, the literature lacks of an objective and standardized decision-making algorithm for the flap choice. The aim of this study is to describe a decision-making algorithm concerning the more appropriate flap, RFFf or ALTf, in the reconstruction of intra-oral soft tissues based on the volumetric analysis of the defect with a pre-operative Magnetic Resonance Imaging (MRI), updating our previous surgical experience. We conducted a retrospective observational study including 77 patients who underwent microsurgical reconstruction with RFFf or ALTf after tumor resection of the soft tissues in the oral cavity. During follow-up, patients were evaluated using the UW-QOL questionnaire. Analyzing the scores of the UW-QOL questionnaire based on the size of the tumor on preoperative MRI we found that for tumor volume <50cc and between 50-70cc, the patients reconstructed with RFFfobtained statistically significant better scores compared to the ALTf group, while for tumor volume >70cc, the patients reconstructed with ALTf reported statistically significant better scores. Pre-operative RMI-guided volumetric assessment of oral cancer plays a key role in the planning of adequate soft tissue reconstruction and can objectively help surgeons in the correct choice of the flap (RFFf vs. ALTf) for each case based on preoperative tumor size, suggesting for defects <50cc and between 50 and 70 cc a reconstruction with RFFf, while for defects >70cc a reconstruction with ALTf.

Evaluation of treatment results of oral cavity tumors with the University of Washington Quality of Life Questionnaire

Objectives: This study aimed to assess the quality of life in patients with oral cavity tumors who underwent either surgical resection or surgical resection followed by radiotherapy (RT) using the University of Washington Quality of Life Questionnaire (UW-QOL). Patients and Methods: The retrospective study included a total of 40 patients (31 males, 9 females; mean age: 64.1±8.3 years; range, 40 to 85 years) who were diagnosed with primary oral cavity tumors and treated between January 2015 and June 2021. Group 1 (n=20) consisted of patients who underwent surgical resection, while Group 2 (n=20) included patients who underwent surgical resection followed by RT. Each participant completed the UW-QOL questionnaire, and the scores were compared between the two groups. Results: There were no significant differences in pain (p=0.149), recreation (p=0.495), and shoulder (p=0.102) parameters. However, the RT group showed significantly lower scores in appearance (p=0.003), activity (p=0.010), swallowing (p=0.001), chewing (p=0.003), speech (p=0.001), taste (p=0.006), saliva (p=0.001), mood (p=0.002), and anxiety (p=0.007) parameters. There were no significant differences in the rates of the most disturbing parameters, such as pain (p=0.548), activity, recreation, shoulder (p=0.292), mood (p=0.311), and anxiety (p=0.072), in the last seven days (p&gt;0.05). However, those who received RT had significantly higher rates of appearance (p=0.04), swallowing (p=0.001), chewing (p=0.001), speech (p=0.002), taste (p=0.035), and saliva (p=0.008) issues in the last seven days. Conclusion: The data we obtained may be helpful during pretreatment patient counseling. Consequently, patients can be informed about the morbidities they may encounter after treatment, and preliminary information can be given to the patients in line with this information.

Repair of Surgical Defect by Pectoralis Major Flap Versus Free Radial Forearm Flap in Buccal Carcinoma: Assessment of Quality of Life

Background: Soft tissue reconstruction of the oral cavity is the most critical factor in achieving a successful functional result. Malignant lesions occurring in the buccal area are usually treated with primary surgical and/or radiotherapy of the head and neck region. Depending on the location and size of the buccal tumor, radical surgical treatment often affects all oral function such as speech, swallowing, chewing, oral rehabilitation, nutrition and appearance. To maximize postoperative function, flap repair is currently the preferred method for reconstruction of buccal defects after major surgery. Among the flaps most commonly used are pedicle pectoralis major myocutaneous flap and the free radial forearm fasciocutaneous flap. The choice of the best reconstructive option is still controversial. Objective: To find out the quality of life after repair of surgical defect by pectoralis major flap versus free radial forearm flap in buccal carcinoma. Methods: This prospective study was conducted in the department Otolaryngology- Head &amp; Neck Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka from September 2017 to August 2019. A total number of 44 cases of buccal carcinoma patient who had the inclusion criteria were enrolled as a study sample. These subjects were selected from the Department of Otolaryngology-Head &amp; Neck Surgery, Department of Oral &amp; Maxillofacial Surgery, Bangabandhu Sheikh Mujib Medical University, Shahbag, National Institute of ENT, Tejgaon, Dhaka. Comparison of nominal or ordinal variables between patients who have undergone surgery with either the RFFF or PMMF were analyzed using a chi-square test. The UW-QOL scores were compared for each domain using the nonparametric Mann-Whitney test. P-value &lt; .05 was accepted as the level of significance. Results: In this study 40 out of 44 patients were completed UW-QOL questionnaires. The median age was 52 (range 40-65years), the male-female ratio was 1.44:1. All were habituated in either smoking or betel leaf/ nut or alcohol. Most of them were illiterate to the primary level of education and suffering from stage- iii tumor. All these variables were statistically insignificant except gender. Patients reconstructed with RFFF felt better in shoulder domains than PMMF but felt worse appearance domains and these were statistically significant in both 3 months and 6 months postoperatively. Conclusion: The study result had shown that reconstruction of the defect after buccal cancer resection using either RFFF or PMMF significantly influences patient’s quality of life. This study will provide valuable information for surgeons who will decide reconstruction modalities for buccal cancer and also will help the patients getting a better outcome. Bangladesh J Otorhinolaryngol 2023; 29(1): 32-38

The application of salvage surgery improves the quality of life and overall survival of extensively recurrent head and neck cancer after multiple operation plus radiotherapy.

The prognosis, choice of reconstruction and the quality of life (QOL) after salvage surgery (SS) for extensively locoregional recurrent/metastatic head and neck cancer (R/M HNC) is an important issue, but there are few reports at present. We analyzed extensively locoregional R/M HNC patients from March 1, 2015, to December 31, 2021 who underwent SS with latissimus dorsi or pectoralis major musculocutaneous flaps. QOL were accessed using QLQ-H&N35 and UW-QOL questionnaire. Wilcoxon signed-rank test was used to compare difference between pre- and post-QOL and Kaplan-Meier curves were used in estimate overall survival (OS) and disease-free survival (DFS). The literature review summarized recent 10 years clinical trials of nonoperative treatment in R/M head and neck cancer. 1362 patients were identified and 25 patients were analyzed after screened. Median age at surgery was 59 years (range 43-77), 15/25(60%) were male and 22/25(88%) chose latissimus dorsi flap. Better mean pain score after applying massive soft tissue flaps revealed relief of severe pain(p<0.001) which strongly associated with improvement of QOL. The improved mean overall QOL score after surgery revealed a better QOL(p<0.001). As of June 1, 2022, 11/25 (44%) of the patients were alive. The 1-year, 2-year OS after SS was 58.4% and 37.2%, while the 1-year, 2-year DFS was 26.2% and 20.9%. The median OS of our study was better than nonoperative treatment of 11 included clinical trials. R/M HNC patients underwent SS can obtain survival benefit. The application of massive soft tissue flap in SS could significantly enhance the QOL for patients with extensively locoregional R/M HNC, especially by relieving severe pain.

Survival rate and quality of life of human papillomaviruse-negative patients with advanced oropharyngeal cancer receiving different treatments

To analyze the survival rates and quality of life of human papillomaviruse (HPV)-negative patients with advanced oropharyngeal cancer after different combined treatments with chemotherapy, surgery and radiotherapy. We retrospectively analyzed the data of patients with oropharyngeal cancer hospitalized in our hospital from January, 2015 to December, 2020, and after case analysis of the clinical, imaging and pathological data, 405 patients were included in this study and grouped according to the treatments they received. Kaplan-Meier and Log-rank analysis were used to calculate the overall survival rate and the survival rate of patients with different treatments. The self-rated quality of life of the tumor-free survivors was assessed using UW-QOL (4) questionnaire and compared among the patients with different treatments. Among the 405 patients included in this study, 146 received treatments with chemotherapy+surgery+radiotherapy (CSRT), 138 received surgery+radiotherapy (SRT) and 121 were treated with radiotherapy+chemotherapy (RCT). The overall survival rates of the 3 groups at 1, 3 and 5 years were 85.1%, 67.1% and 56.9%, respectively, and the survival rates of patients receiving CSRT, SRT and RCT did not differ significantly (P > 0.05). A total of 280 UW-QOL (4) questionnaires were distributed and 202 (72.14%) were retrieved. The average total scores decreased in the order of CSRT > SRT > RCT; the scores were significantly higher in CSRT group than in SRT and RCT (P < 0.05), but did not differ significantly between SRT and RCT groups (P > 0.05). CSRT, SRT and RCT are all treatment options for locally advanced oropharyngeal cancer, but CSRT may achieve better quality of life of the patients than SRT and RCT.

Analysis of Quality of Life With 3D-Printed Model vis-á-vis Conventional Procedure in Oral &amp; Maxillofacial Surgery – An Empirical Study

Aims and Objectives 3d-printed models (bio-models) have become a useful tool in the armamentarium of surgeons for improved surgical planning in the recent past. This study directs at reinforcing the incorporation of these bio-models as a handy tool in treatment planning, resident training, patient education and record maintenance. The aim of this empirical study was to compare the outcome in reconstructive maxillofacial surgery when planned using 3d-printed model and without 3d-printed model (conventional). The objectives were to assess and compare the intraoperative time taken during reconstruction, the immediate post-operative experience (pain, mouth opening and incidence of infection) and the quality of life using University of Washington (UW-QOL) questionnaire during follow up. Methods This retrospective comparative study was conducted in Department of Oral &amp; Maxillofacial Surgery, from March 2018 to March 2020. It included 50 cases consisting variety of pathologic and traumatic maxillofacial defects and they were grouped into with 3d-printed model (Group A) and without 3d-printed model (Group B). The groups were further subclassified based on maxillary (MR) and mandibular reconstruction [vascularized flaps (VFFF), non-vascularised grafts (NVG), reconstruction plate alone (RP)]. We compared intra operative time taken along with immediate post-operative parameters (pain, mouth opening and presence of infection) and patient’s quality of life using UW-QOL questionnaire. These values were taken for comparison and statistical analysis was done by unpaired t-test. Result There was 14.75% (35.26 minutes) mean reduction in operative time (* P = .029) and reduction in mean visual analogue score (VAS) (* P = .003) with statistically significant difference. However, increase in immediate post-operative mouth opening was not found to be statistically significant difference ( P =.471). The comparison of the social and functional domain of UW-QOL showed statistically significant P-value in saliva (*0.004) and mood (*0.002) with regard to NVG. In RP group, pain (*0.026), swallowing (*0.041) and taste (*0.008) was found to be statistically significant. In MR group, only pain (*0.037) showed statistically significant difference. Conclusion Use of 3d-printed model to guide and assist in surgical procedures have provided promising results. Based on this study, we found that there is decreased intraoperative time and post-operative pain score when 3d-printed model were used. The patient’s quality of life was also found to be better in terms of reduction in pain, salivary secretion and mood elevation. With increased success rate, the authors are of the strong opinion that it is time to revisit the surgical protocol used for reconstruction and include 3d-printed model as a primary tool or technology across the board for all patients notwithstanding the comparative cost, as the results offset the financial aspect.

Perfil da qualidade de vida três meses ou mais após o término da radioterapia adjuvante utilizada para o tratamento do câncer de cabeça e pescoço em um Centro de Assistência de Alta Complexidade em Oncologia

The treatment of head and neck cancer (HNC) is multimodal and can generate different physical and psychological impairments. The aim of this study was to assess the quality of life profile of patients with HNC, in search of possible therapeutic targets that can be improved. This is a descriptive, cross-sectional, observational study, developed at a High Complexity Care Center in Oncology. Data were collected through anamnesis and the University of Washington quality of life questionnaire (UW-QOL). The sample consisted of 68 patients with head and neck cancer who underwent adjuvant radiotherapy for at least 90 days. There was a predominance of males (89%) and an involvement of the oropharynx (69%). In addition to radiation therapy, 53% of individuals also underwent surgery and 65% chemotherapy. Stomatognathic functions were the most affected, followed by negative implications related to activities of daily living and psychological aspects. According to the nature of the domains found in the UW-QOL Questionnaire, the low scores observed in the questions related to the activities of daily living and in the components of the psychological status assessment, it is pertinent to assume that the late complications imposed by both the pathophysiology of the HNC as well as the antineoplastic treatment should be approached by a multidisciplinary team aligned with the synergistic objective of rehabilitating stomatognathic functions, nutrition, and physical capacity. Although our data do not suggest emotional impairments, additional support from a psychologist could be considered in order to strengthen and motivate engagement in the rehabilitation of the complex clinical condition intrinsic to HNC.

Comparative study for closure methods of maxillary defects after maxillectomy, a free flap versus a maxillary obturator

ObjectiveReconstruction with a free flap after maxillectomy is not unified, and reconstruction techniques are applied according to the surgeon’s preference. The present study evaluated patient characteristics (sex and age), clinical factors (operation time, bleeding volume, hospitalization, number of remaining maxillary teeth, maxillary defect), and quality of life of patients after surgery who did or did not undergo reconstruction at the time of resection of maxillary malignant gingival tumors. MethodsWe conducted a retrospective case control study. The patient sample consisted of 38 patients who underwent maxillectomy as maxillary gingival malignant tumor ablative surgery between 2007 and 2018. Thirteen patients received reconstruction with a free flap (reconstruction group) and 25 patients received reconstruction with an obturator (non-reconstruction group). Quality of life was assessed using the University of Washington Quality of Life questionnaire (UW-QOL) for patients who were able to respond. There were seven valid responses in the reconstruction group and seven valid responses in the non-reconstruction group. Differences in questionnaire items between groups were evaluated using the Mann–Whitney U test. ResultsThe reconstruction group had significantly longer operation time, larger bleeding volume, and longer hospitalization time than the non-reconstruction group (P < 0.05 for all). However, no significant differences were observed in UW-QOL questionnaire items between the two groups. ConclusionThis study showed that there was no significant difference in postoperative patient QOL between reconstruction and non-reconstruction following maxillectomy.

Quality of life after total laryngectomy: impact of different vocal rehabilitation methods in a middle income country

IntroductionThe impact of advanced laryngeal cancer and its extensive surgical treatments cause significant morbidity for these patients. Total laryngectomy impacts essential functions such as breathing, communication and swallowing, and may influence the quality of life as well as affecting the social life of laryngeal cancer patients.ObjectiveDescribe the quality of life and analyze the factors associated with the reduced quality of life in patients who have undergone total laryngectomy.MethodObservational cross-sectional study was carried out to evaluate the quality of life of patients who had undergone total laryngectomy due to laryngeal cancer. The fourth version of the UW-QOL Quality of Life Assessment Questionnaire from Washington University, validated for Portuguese, was used.ResultsThe study population was 95 patients, and the mean composite score of the QOL was 80.4. In the subjective domains the majority of the patients (38.9%) reported they felt much better at present compared to the month before being diagnosed with cancer. When questioned about how they evaluated their health-related quality of life, there was a predominance of those who considered it good (43.2%), and most considered they had a good quality of life (46.3%) considering personal well-being. The overall quality of life was considered good to excellent by 83.2% of the patients. Patients with tracheoesophageal prosthesis reported a better quality of life, compared to patients using an electrolarynx or esophageal voice.ConclusionThe high mean value of the composite score for quality of life revealed that the patients assessed their quality of life positively. The absence of vocal emission was the only variable associated with a lower quality of life within the composite score according to the UW-QOL questionnaire.

Assessment of Quality of Life among Head and Neck Cancer Patients

Objective: Head and neck cancer is a common malignancy with increasing incidence worldwide. This study evaluates the quality of life of the patients undergoing treatment at the oncology center in Yazd, Iran. Methods: This cross-sectional study was conducted on 29 patients with oral and head and neck cancer that were referred to the oncology center of Shahid Sadoughi hospital in Yazd between May 2015 and February 2016. Data were collected using the UW-QOL questionnaire and a demographic questionnaire. The illness-related information was obtained from the patients’ medical records. Questionnaires were administered before the treatment and 6 months after its completion. Data analysis was performed in SPSS 21 using chi-square and ANOVA tests. P-values of less than 0.05 were considered statistically significant. Results: The sample consisted of 17 (58.6%) women and 12 (41.4%) men with a mean age of 40.00±14.30 years. The most frequent cancer location was the oral cavity and the most frequent treatment method was surgery. The mean score of quality of life before and after treatment was 12.60±2.81 and 11.39±2.63 respectively. The most important issues of the patients before and after treatment were pain and saliva respectively. Stage 3 and 4 patients had a significantly lower quality of life than stage 1 and 2 patients. Conclusion: The study found that undergoing treatment affects some dimensions of quality of life. Hence, choosing the best treatment method with due attention to side effects and follow-up sessions is recommended.

Quality of life in Iranian patients with head-and-neck cancer.

BACKGROUND:The goal of treating cancer patients is to cure the patients and improve their quality of life (QoL) during their illness. The aim of this research was to assess the QoL in Iranian patients with head-and-neck cancer by European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Head and Neck 35 (EORTC QLQ-H&N35) and University of Washington Quality of Life Questionnaire (UW-QoL).MATERIALS AND METHODS:In this cross-sectional study, Iranian variation of EORTC QLQ-H&N35 and UW-QoL questionnaires was administered to 210 patients with head-and-neck cancer. Patients who visited the Department of Oncology at Omid Hospital in Isfahan, Shafa Hospital in Kerman, and Emam Khomeini Hospital in Tehran were selected. Kruskal–Wallis test, general linear model multivariate of variance, multiple regression models, and SPSS version 21 were used for statistical analysis.RESULTS:In the present research work, 210 patients with cancer in head and neck were under investigation, such that 128 patients (61%) were male and 82 patients (39%) were female. Only the patients with laryngeal cancer scored worse for dyspnea according to the scores from UW-QoL questionnaires. There were statistically significant differences for pain, swallowing, social eating, social contact, speech, taste/smell, and trismus based on the QLQ-H&N35. Lower QoL was observed in patients with advanced (Stage III + IV) tumors and treated with radiotherapy plus surgical method.CONCLUSION:The study showed that quality of life differs due to location of tumor, stage of cancer, and treatment type.

QUALITY OF LIFE EVALUATION ACCORDING TO THE LOCATION OF THE TUMOR IN PATIENTS DIAGNOSED WITH HEAD AND NECK CANCER

Objective To evaluate the quality of life according to the location of the tumor in patients diagnosed with head and neck cancer. Study Design This is a cross-sectional study. The sample consisted of 74 patients with a diagnosis of head and neck cancer that were treated from January 2017 to January 2018 at 2 hospitals located in Feira de Santana city (Bahia-Brazil). The socioeconomic and clinical data were collected in a specific form and in the medical record, and the quality of life evaluation was performed using the University of Washington Quality of Life Questionnaire (UW-QOL), version 4. Results Regarding the composite quality of life domain of the UW-QOL questionnaire, the patients had a mean of 848, and chewing and anxiety were the most affected domains; saliva and shoulder were the least affected domains. When comparing tumor location with quality of life, the oral tumors had the worst mean (802) and thyroid tumors, the best mean (1053), being statistically significant (P = .044). Conclusions Head and neck cancer is a clinical condition that affects the patient's quality of life. The location of the tumor will determine the treatment to which the patient will be subjected and his or her quality of life.

Validity and Reliability of Tamil translated University of Washington Quality of Life Questionnaire for Head and Neck Cancers.

Background:Quality of life is an important outcome measure used both in research and patient care across all cultural healthcare settings. Objective:This study is aimed to evaluate the validity and reliability of interviewer-administered Tamil translated University of Washington Quality of Life Questionnaire (Version 4) in a setting with low literacy. Methods:The study was done in a tertiary care teaching institute in Puducherry, South India. The translation was done by using ‘forward-backward translation method.’ A hundred subjects diagnosed with head and neck cancer (HNC) were interviewed before the initiation of treatment. The Tamil version of University of Washington Quality of Life Questionnaire (UWQOL) questionnaire was validated using the Tamil version of the World Health Organization Quality of Life-Brief questionnaire (WHOQOL-BREF) version. Inter-rater reliability and test-retest reliability was also assessed. Item-total correlation and Cronbach alpha were calculated for assessing validity and internal consistency respectively. Results:In the Tamil version of UWQOL, social-emotional subscale was more affected than physical subscale. The domains such as mood, anxiety, and pain were most affected. The subscale scores were significantly different between those with early and late cancer. Tamil version of UWQOL showed moderate correlation with WHOQOL-BREF. The Tamil version of UWQOL had good test-retest and inter-rater agreement. Item-total correlation for the subscales was >0.80. The internal consistency of the Tamil Questionnaire was acceptable with Cronbach Alpha of 0.69. Conclusion:The Tamil version of UWQOL questionnaire is a short, valid and reliable for HNC patients of low literacy.

Quality of life assessment in temporomandibular joint ankylosis patients after interpositional arthroplasty: a prospective study

Temporomandibular joint (TMJ) ankylosis significantly impacts both physical and psychosocial patient wellbeing. A complete evaluation of treatment outcomes necessitates knowing the extent to which a patient’s quality of life (QoL) is impacted. This study was performed to evaluate the impact of TMJ ankylosis on QoL in 25 TMJ ankylosis patients treated by interpositional arthroplasty. The patients completed OHIP-14 and UWQoL questionnaires once before and then at 3 months after the surgery. There was a significant improvement in mean cumulative scores for both questionnaires. With the exception of functional limitation, all OHIP domains showed significant improvement. Preoperatively, the worst scores were found in the psychological distress domain, followed by the social handicap, physical pain and physical disability domains. More than half of the subjects (56%) reported having suicidal thoughts. Amongst the individual UWQoL domains, appearance, chewing, anxiety (P < 0.01), recreation and mood (P < 0.05) showed improved scores. Appearance and chewing were the top ranked priority domains before and after surgery. No significant change was found in speech, taste, sleep, or breathing. Psychosocial factors were found to play a much bigger role than previously thought. The physical, psychological, and social factors were intricately related and dynamically interacted with each other. Surgical treatment produced a definitive QoL improvement in the patients.

Quality of life after mandibulectomy: the impact of the resected subsite

The purpose of this study was to identify the factors that impact the quality of life (QOL) scores of patients undergoing mandibulectomy.All patients with a diagnosis of an oral cavity neoplasm involving the mandible who underwent a mandibulectomy between January 1, 2000 and December 31, 2015 and completed a University of Washington QOL questionnaire (UW-QOL) were included in the study.Fifty-eight patients fulfilled all inclusion criteria and completed the UW-QOL questionnaire. Forty patients (69%) underwent a segmental mandibulectomy and 18 patients underwent a marginal mandibulectomy. Forty-eight patients (82.7%) had a free flap reconstruction. There was no significant difference in the QOL scores between patients who underwent a marginal or a segmental mandibulectomy. In contrast, patients who underwent symphysial resection reported significantly worse scores in various domains compared to patients with body or ramus segmental mandibulectomy.Patients who underwent a segmental mandibulectomy that included the symphysis had worse outcomes in chewing, recreation, health-related and social QOL domains compared to those whose mandibulectomy did not include the symphysis.

Effects of Ultrasound, Laser and Exercises on Temporomandibular Joint Pain and Trismus Following Head and Neck Cancer.

ObjectiveTo compare the effects of low intensity ultrasound (LIUS), traditional exercise therapy (TET), low level laser therapy (LLLT) and TET on temporomandibular joint (TMJ) pain and trismus following recovery from head and neck cancer (HNC).MethodsSixty participants following, who had experienced HNC, were randomly allocated to three groups of 20 people each. Each group received different therapy. Group A received LIUS and TET; group B received LLLT and TET; while group C received TET. All 60 participants were evaluated under the visual analog scale (VAS), the University of Washington Quality of Life questionnaire (UW-QOL) and the Vernier caliper scale (VCS) at the beginning of the therapies and after 4 weeks.ResultsANOVA test revealed significant improvements across all three groups with outcomes of p<0.05. The results of the UW-QOL questionnaire showed a significant difference between groups A, B and C in favor of group A (p<0.05). The VAS results showed a more improvement in group A as compared to group B (p<0.05), while there was no statistical difference between groups B and C (p>0.05). The VCS results showed more improvement for the individuals in group B as compared to those in group C (p<0.05), while there was minimal difference between groups A and B (p>0.05).ConclusionThe LIUS and TET are more effective than LLLT and/or TET in reducing TMJ pain and trismus following HNC.

Quality of life after free flap surgery for cancer of the head and neck in patients with or without postoperative complications.

Despite advances in surgical techniques, postoperative complications are frequent after free flap surgery for cancer of the head and neck. The present study assessed quality of life (QOL) in patients with and without postoperative complications. QOL was evaluated using RAND-36, EORTC-C30 and H&N-35, and UW-QOL questionnaires. Of 53 assessed patients, 29 (54.7%) had at least one complication. Those with medical complications (n = 12, 22.6%) had significantly lower QOL in all domains of RAND-36 except emotional well-being. They also reported lower scores in EORTC-C30 domains of financial difficulties, pain, and insomnia and UW-QOL domains of pain, activity, and recreation. The QOL for patients without complications was comparable to the general population. QOL after free flap surgery for cancer of the head and neck is reduced in patients with postoperative medical complications.

Quality of life of head and neck cancer patients in urban and regional areas: An Australian perspective.

Head and neck cancer treatment affects quality of life. There are differences in quality of life outcomes and perceived supportive care needs between cancer patients living in metropolitan and regional-remote areas. This study investigated quality of life over the first 6months following head and neck cancer diagnosis and observed differences in quality of life by geographical location. Prospective observational study. Tertiary hospital in Brisbane, Australia. Newly diagnosed patients who were referred for the diagnosis, and/or treatment of head and neck cancer. Quality of life was measured by the University of Washington Quality of Life Survey, version 4 (UW-QoL). Participants completed the UW-QoL questionnaire prior to starting treatment, 1 month and 6 months post treatment. Metropolitan and regional or remote status was classified according to the Australian Standard Geographic Classification-Remoteness Area system. Ninety-five participants were included at baseline; 49 and 41 participants completed the 1-month and 6-month follow-ups, respectively. Scores in most UW-QoL domains decreased between baseline and 1 month post treatment and increased towards pre-treatment scores at the 6-month follow-up (except for anxiety and saliva). Pain at baseline was significantly worse in the regional-remote participants compared with metropolitan participants. No other statistically significant differences in UW-QoL score by geographical location were observed. The findings generally did not support significant differences in quality of life outcome between metropolitan and regional-remote head and neck cancer patients. The difference in pain experience between metropolitan and regional-remote groups requires further investigation.

The use of health related quality of life data to produce information sheets for patients with head and neck cancer.

Health related quality of life information gives patients and carers an indication of how they will be affected following treatment. Such knowledge can promote realistic expectations and help patients come to terms with their outcome. The aim of this paper is to describe the background development of patient information sheets produced at our unit. The data were compiled using a common head and neck cancer specific quality of life questionnaire (University of Washington Quality of Life [UW-QOL]). There are 12 domains comprising activity, appearance, anxiety, chewing, mood, pain, recreation, saliva, shoulder, speech, swallowing and taste. The data were collected over 19 years at our unit and focus on follow-up records at around 2 years as this gives a good indication of health related quality of life in survivorship. UW-QOL questionnaires were available from 1,511 patients treated following primary diagnosis of head and neck cancer, and there were 24 subgroups based on cancer site, stage and treatment. There were 2 other subgroups: 132 having transoral laser resection and 176 having laryngectomy. The patient and carer research forum helped to design the information sheets, which display overall quality of life, percentages with 'good' outcome and 'significant problem' by domain, and the most important domains. Three examples are included in this paper: early stage oral cancer treated by surgery alone, early laryngeal cancer treated by surgery alone, and late stage oropharyngeal cancer treated by surgery and postoperative radiotherapy. All 26 subgroup information sheets are available in booklet form and on the internet. How the surgical community best utilises this type of resource needs further research.

Evaluation of oral health status and quality of life of head and neck cancer patients after radiation therapy

Introduction. Neoplasm of the head and neck can be treated surgically, by radiation, chemotherapy, or using combination of these methods. In contrast to surgical and radiation treatment which mostly have a local effect, chemotherapy in addition to local have also a systemic effect. Both XRT in oral region and chemotherapy can affect oral health. The aim of this study was to assess the oral health status and quality of life in patients with head and neck cancer after receiving radiation therapy. Material and Methods. Quantitative, analytical and cross-sectional research methods along with the application of UW-QOL questionnaire version 4, were used. Seventy one patients of the outpatient facilities at two cancer hospitals in the state of Para?ba, Brazil, were included in the study. Oral health status was evaluated using the Lockhart and Clark criteria. Linear Poisson and Logistic Regression tests were applied to assess associations between the variables using a significance level of 5%. Results. Of the total number of patients, 71.83% were male, the average age was 62 years and 57.74% were non-Caucasian. The group that received dental monitoring and follow-up attained the highest (830.13) Quality of life scores, including: ?pain? (93.13) and ?taste? (83.07). The highest score for oral health in the group that did not receive dental monitoring and follow-up treatment was 4.08 for ?oral hygiene?. Conclusion. Dental monitoring and follow-up should begin before radiation therapy, given that both the illness and methods used for the treatment negatively affect patients? quality of life.