Effect of submental flap reconstruction versus obturator rehabilitation after maxillectomy on quality of life: a randomized clinical trial |
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| Affiliation: | 1. Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Cairo University, Cairo, Egypt;2. Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Sana’a University, Sana’a, Yemen;3. Department of Prosthodontics, College of Dentistry, Taibah University, Madinah, Saudi Arabia;4. Department of Prosthodontics, College of Dentistry, Ibb University, Ibb, Yemen;5. Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Fayoum University, Fayoum, Egypt;1. Oral and Maxillofacial Surgery Department, Royal Brisbane and Women’s Hospital, Herston, Queensland, Australia;2. Saliva and Liquid Biopsy Translational Research Team, Institute of Health and Biomedical Innovation, School of Biomedical Science, Queensland University of Technology, Brisbane, Queensland, Australia;3. The School of Biomedical Engineering, University of Technology Sydney, Sydney, New South Wales, Australia;4. Department of Biomedical Engineering, Institute of Molecular Medicine, Sechenov First Moscow State Medical University, Moscow, Russia;1. Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, PR China;2. Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, PR China;3. Department of Epidemiology and Biostatistics, Jiangsu Key Laboratory of Cancer Biomarkers, Prevention and Treatment, Cancer Centre, Nanjing Medical University, Nanjing, PR China;1. Department of Oral and Maxillofacial Surgery, and Plastic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan;2. Department of General Surgical Science, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan;3. Department of Dermatology, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan;1. Araçatuba School of Dentistry – UNESP, São Paulo, Brazil;2. Bauru School of Dentistry, University of São Paulo – USP, São Paulo, Brazil;3. Department of Diagnosis and Surgery, Araçatuba School of Dentistry – UNESP, São Paulo, Brazil;1. Department of Oral and Maxillofacial Surgery, Tokai University School of Medicine, Isehara, Kanagawa, Japan;2. Department of Clinical Technology, Medical Technology Support Division, Tokai University Hospital, Isehara, Kanagawa, Japan;3. Department of Radiation Oncology, Tokai University School of Medicine, Isehara, Kanagawa, Japan |
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| Abstract: | The surgical removal of a maxillary tumour will result in an oronasal communication, which can negatively affect the patient’s life and daily functions. Following maxillectomy, the defect can be treated with a prosthetic obturator or microvascular flap. However, the gold standard technique remains controversial. The aim of this study was to evaluate and compare quality of life (QoL) outcomes of submental island flap versus maxillary obturator reconstruction after partial maxillectomy. Sixty patients indicated for maxillectomy were allocated randomly to two equal-sized groups. Control group patients underwent reconstruction with a surgical obturator, while intervention group patients underwent submental island flap reconstruction. Patient QoL was evaluated at the 6-month follow-up using the University of Washington Quality of Life Questionnaire. Statistically significant differences in QoL were found between the two groups. Chewing (P = 0.034), swallowing (P < 0.001), speech (P = 0.009), taste (P = 0.04), mood (P = 0.01), and anxiety (P = 0.003) domains showed a statistically significant improvement in the submental group compared to the obturator group. However, the obturator group showed a greater improvement in appearance (P < 0.001). The masticatory function scores in the obturator group were significantly higher after obturator rehabilitation (P < 0.001). In conclusion, this study found that submental flap reconstruction provided better function and QoL than the obturator. This reconstruction was associated with less pain and better pronouncing of words, chewing, swallowing food, and psychosocial adjustment. |
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| Keywords: | palatal obturator submental flab quality of life |
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