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Published in: World Journal of Surgical Oncology 1/2013

Open Access 01-12-2013 | Research

Measures of health-related quality of life and socio-cultural aspects in young patients who after mandible primary reconstruction with free fibula flap

Authors: Juanfang Zhu, Yan Xiao, Fei Liu, Jing Wang, Wenli Yang, Weihong Xie

Published in: World Journal of Surgical Oncology | Issue 1/2013

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Abstract

Background

The 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.

Methods

The 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.

Results

Using 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.

Conclusions

Mandible 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.
Literature
1.
go back to reference Shpitzer T, Neligan PC, Gullane PJ, Boyd BJ, Gur E, Rotstein LE, Brown DH, Irish JC, Freeman JE: The free iliac crest and fibula flaps in vascularized oromandibular reconstruction: comparison and long-term evaluation. Head Neck. 1999, 21: 639-647. 10.1002/(SICI)1097-0347(199910)21:7<639::AID-HED8>3.0.CO;2-T.CrossRefPubMed Shpitzer T, Neligan PC, Gullane PJ, Boyd BJ, Gur E, Rotstein LE, Brown DH, Irish JC, Freeman JE: The free iliac crest and fibula flaps in vascularized oromandibular reconstruction: comparison and long-term evaluation. Head Neck. 1999, 21: 639-647. 10.1002/(SICI)1097-0347(199910)21:7<639::AID-HED8>3.0.CO;2-T.CrossRefPubMed
2.
go back to reference Moro A, Cannas R, Boniello R, Gasparini G, Pelo S: Techniques on modeling the vascularized free fibula flap in mandibular reconstruction. J Craniofac Surg. 2009, 20: 1571-1573. 10.1097/SCS.0b013e3181b0db5c.CrossRefPubMed Moro A, Cannas R, Boniello R, Gasparini G, Pelo S: Techniques on modeling the vascularized free fibula flap in mandibular reconstruction. J Craniofac Surg. 2009, 20: 1571-1573. 10.1097/SCS.0b013e3181b0db5c.CrossRefPubMed
3.
go back to reference Taylor GI, Miller GD, Ham FJ: The free vascularized bone graft. A clinical extension of microvascular techniques. Plast Reconstr Surg. 1975, 55: 533-544. 10.1097/00006534-197505000-00002.CrossRefPubMed Taylor GI, Miller GD, Ham FJ: The free vascularized bone graft. A clinical extension of microvascular techniques. Plast Reconstr Surg. 1975, 55: 533-544. 10.1097/00006534-197505000-00002.CrossRefPubMed
4.
go back to reference Hidalgo DA: Fibula free-flap: a new method of mandible reconstruction. Plast Reconstr Surg. 1989, 84: 71-79. 10.1097/00006534-198907000-00014.CrossRefPubMed Hidalgo DA: Fibula free-flap: a new method of mandible reconstruction. Plast Reconstr Surg. 1989, 84: 71-79. 10.1097/00006534-198907000-00014.CrossRefPubMed
5.
go back to reference Cordeiro PG, Disa JJ, Hidalgo DA, Hu QY: Reconstruction of the mandible with osseous free flaps: a 10-year experience with 150 consecutive patients. Plast Reconstr Surg. 1999, 104: 1314-1320. 10.1097/00006534-199910000-00011.CrossRefPubMed Cordeiro PG, Disa JJ, Hidalgo DA, Hu QY: Reconstruction of the mandible with osseous free flaps: a 10-year experience with 150 consecutive patients. Plast Reconstr Surg. 1999, 104: 1314-1320. 10.1097/00006534-199910000-00011.CrossRefPubMed
6.
go back to reference Chang YM, Wallace CG, Tsai CY, Shen YF, Hsu YM, Wei FC: Dental implant outcome after primary implantation into double-barreled fibula osteoseptocutaneous free flap-reconstructed mandible. Plast Reconstr Surg. 2011, 128: 1220-1228. 10.1097/PRS.0b013e318230c6a9.CrossRefPubMed Chang YM, Wallace CG, Tsai CY, Shen YF, Hsu YM, Wei FC: Dental implant outcome after primary implantation into double-barreled fibula osteoseptocutaneous free flap-reconstructed mandible. Plast Reconstr Surg. 2011, 128: 1220-1228. 10.1097/PRS.0b013e318230c6a9.CrossRefPubMed
7.
go back to reference Xiao FL, Xin P: What is the price to pay for a free fibula flap? A systematic review of donor-site morbidity following free fibula flap surgery. Plast Reconstr Surg. 2012, 129: 657-674. 10.1097/PRS.0b013e3182402d9a.CrossRef Xiao FL, Xin P: What is the price to pay for a free fibula flap? A systematic review of donor-site morbidity following free fibula flap surgery. Plast Reconstr Surg. 2012, 129: 657-674. 10.1097/PRS.0b013e3182402d9a.CrossRef
8.
go back to reference Chandu A, Smith AC, Rogers SN: Health-related quality of life in oral cancer: a review. J Oral Maxillofac Surg. 2006, 64: 495-502. 10.1016/j.joms.2005.11.028.CrossRefPubMed Chandu A, Smith AC, Rogers SN: Health-related quality of life in oral cancer: a review. J Oral Maxillofac Surg. 2006, 64: 495-502. 10.1016/j.joms.2005.11.028.CrossRefPubMed
9.
go back to reference Murphy BA, Ridner S, Wells N, Dietrich M: Quality of life research in head and neck cancer: a review of the current state of the science. Crit Rev Oncol Hematol. 2007, 62: 251-267. 10.1016/j.critrevonc.2006.07.005.CrossRefPubMed Murphy BA, Ridner S, Wells N, Dietrich M: Quality of life research in head and neck cancer: a review of the current state of the science. Crit Rev Oncol Hematol. 2007, 62: 251-267. 10.1016/j.critrevonc.2006.07.005.CrossRefPubMed
10.
go back to reference Ware JE, Sherbourne C: The MOS 36-item short-form health survey (SF-36). Med Care. 1992, 30: 473-483. 10.1097/00005650-199206000-00002.CrossRefPubMed Ware JE, Sherbourne C: The MOS 36-item short-form health survey (SF-36). Med Care. 1992, 30: 473-483. 10.1097/00005650-199206000-00002.CrossRefPubMed
11.
go back to reference Rogers SN, Lowe D, Fisher SE, Brown JS, Vaughan ED: Health-related quality of life and clinical function after primary surgery for oral cancer. Br J Oral Maxillofac Surg. 2002, 40: 11-18. 10.1054/bjom.2001.0706.CrossRefPubMed Rogers SN, Lowe D, Fisher SE, Brown JS, Vaughan ED: Health-related quality of life and clinical function after primary surgery for oral cancer. Br J Oral Maxillofac Surg. 2002, 40: 11-18. 10.1054/bjom.2001.0706.CrossRefPubMed
12.
go back to reference Khadka A, Liu Y, Li JH, Zhu SS, Luo EF, Ge HJ: Changes in quality of life after orthognathic surgery: a comparison based on the involvement of the occlusion. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011, 112: 719-725. 10.1016/j.tripleo.2011.01.002.CrossRefPubMed Khadka A, Liu Y, Li JH, Zhu SS, Luo EF, Ge HJ: Changes in quality of life after orthognathic surgery: a comparison based on the involvement of the occlusion. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011, 112: 719-725. 10.1016/j.tripleo.2011.01.002.CrossRefPubMed
13.
go back to reference Li W, Yang YX, Liu F, Cheng Y, Xu L, Sun C: Assessment of quality of life of patients with oral cavity cancer who have had defects reconstructed with free anterolateral thigh perforator flaps. Br J Oral Maxillofac Surg. 2013, 51: 497-501. 10.1016/j.bjoms.2012.09.005.CrossRefPubMed Li W, Yang YX, Liu F, Cheng Y, Xu L, Sun C: Assessment of quality of life of patients with oral cavity cancer who have had defects reconstructed with free anterolateral thigh perforator flaps. Br J Oral Maxillofac Surg. 2013, 51: 497-501. 10.1016/j.bjoms.2012.09.005.CrossRefPubMed
14.
go back to reference Girish RS, Aditya TN, Gopinath KS, Anand K: Free fibula flap in the reconstruction of mandible: a report of six cases. J Maxillofac Oral Surg. 2009, 8: 275-278. 10.1007/s12663-009-0067-y.CrossRef Girish RS, Aditya TN, Gopinath KS, Anand K: Free fibula flap in the reconstruction of mandible: a report of six cases. J Maxillofac Oral Surg. 2009, 8: 275-278. 10.1007/s12663-009-0067-y.CrossRef
15.
go back to reference Rogers SN, Scott J, Chakrabati A, Lowe D: The patients’ account of outcome following primary surgery for oral and oropharyngeal cancer using a ‘quality of life’ questionnaire. Eur J Cancer Care. 2008, 17: 182-188. 10.1111/j.1365-2354.2007.00832.x.CrossRef Rogers SN, Scott J, Chakrabati A, Lowe D: The patients’ account of outcome following primary surgery for oral and oropharyngeal cancer using a ‘quality of life’ questionnaire. Eur J Cancer Care. 2008, 17: 182-188. 10.1111/j.1365-2354.2007.00832.x.CrossRef
16.
go back to reference Hsing CY, Wong YK, Wang CP, Wang CC, Jiang RS, Chen FJ, Liu SA: Comparison between free flap and pectoralis major pedicled flap for reconstruction in oral cavity cancer patients – a quality of life analysis. Oral Oncol. 2011, 47: 522-527. 10.1016/j.oraloncology.2011.03.024.CrossRefPubMed Hsing CY, Wong YK, Wang CP, Wang CC, Jiang RS, Chen FJ, Liu SA: Comparison between free flap and pectoralis major pedicled flap for reconstruction in oral cavity cancer patients – a quality of life analysis. Oral Oncol. 2011, 47: 522-527. 10.1016/j.oraloncology.2011.03.024.CrossRefPubMed
17.
go back to reference Farhadi J, Valderrabano V, Kunz C, Kern R, Hinterman B, Pierer G: Free fibula donor-site morbidity: clinical and biomechanical analysis. Ann Plast Surg. 2007, 58: 405-410. 10.1097/01.sap.0000241948.36784.4e.CrossRefPubMed Farhadi J, Valderrabano V, Kunz C, Kern R, Hinterman B, Pierer G: Free fibula donor-site morbidity: clinical and biomechanical analysis. Ann Plast Surg. 2007, 58: 405-410. 10.1097/01.sap.0000241948.36784.4e.CrossRefPubMed
18.
go back to reference Markkanen LM, Makitie AA, Haapanen ML, Suominen E, Asko SS: Quality of life after free-flap reconstruction in patients with oral and pharyngeal cancer. Head Neck. 2006, 28: 210-216. 10.1002/hed.20329.CrossRef Markkanen LM, Makitie AA, Haapanen ML, Suominen E, Asko SS: Quality of life after free-flap reconstruction in patients with oral and pharyngeal cancer. Head Neck. 2006, 28: 210-216. 10.1002/hed.20329.CrossRef
19.
go back to reference Bartaire E, Mouawad F, Mallet Y, Milet P, El Bedoui S, Ton VJ, Chevalier D, Lefebvre JL: Morphologic assessment of mandibular reconstruction by free fibula flap and donor-site functional impairment in a series of 23 patients. Eur Ann Otorhinolaryngol Head Neck Dis. 2012, 129: 230-237. 10.1016/j.anorl.2011.06.004.CrossRefPubMed Bartaire E, Mouawad F, Mallet Y, Milet P, El Bedoui S, Ton VJ, Chevalier D, Lefebvre JL: Morphologic assessment of mandibular reconstruction by free fibula flap and donor-site functional impairment in a series of 23 patients. Eur Ann Otorhinolaryngol Head Neck Dis. 2012, 129: 230-237. 10.1016/j.anorl.2011.06.004.CrossRefPubMed
20.
go back to reference Petruson KM, Silander EM, Hammerlid EB: Quality of life as predictor of weight loss in patients with head and neck cancer. Head Neck. 2005, 27: 302-310. 10.1002/hed.20172.CrossRefPubMed Petruson KM, Silander EM, Hammerlid EB: Quality of life as predictor of weight loss in patients with head and neck cancer. Head Neck. 2005, 27: 302-310. 10.1002/hed.20172.CrossRefPubMed
Metadata
Title
Measures of health-related quality of life and socio-cultural aspects in young patients who after mandible primary reconstruction with free fibula flap
Authors
Juanfang Zhu
Yan Xiao
Fei Liu
Jing Wang
Wenli Yang
Weihong Xie
Publication date
01-12-2013
Publisher
BioMed Central
Published in
World Journal of Surgical Oncology / Issue 1/2013
Electronic ISSN: 1477-7819
DOI
https://doi.org/10.1186/1477-7819-11-250

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