A preliminary analysis of patient reported outcomes following posterolateral mandible reconstruction: The role of flap type Journal Article
| Authors: | Cohen, Z.; Zhang, K. K.; Kim, M.; Haglich, K.; Woods, J.; Monge, J.; Matros, E.; Boyle, J. O.; McCarthy, C.; Cracchiolo, J. R.; Cohen, M. A.; Shahzad, F.; Nelson, J. A.; Allen, R. J. |
| Article Title: | A preliminary analysis of patient reported outcomes following posterolateral mandible reconstruction: The role of flap type |
| Abstract: | Background: The choice of tissue type for free flap reconstruction of posterolateral mandible resections is dependent on patient and defect characteristics. We compared clinical and patient-reported outcomes following reconstruction of these defects with a soft tissue or bony free flap. Methods: A retrospective review was performed on patients who underwent posterolateral segmental mandibulectomy with immediate free flap reconstruction at MSKCC from 2006 to 2021. Outcomes of interest were patient-reported outcome measures (PROMs) assessed by FACE-Q surveys and complications at the flap recipient site. Results: Ninety patients received a bony flap and 24 patients received a soft tissue flap. Patients reconstructed with soft tissue flaps had greater rates of composite soft tissue defects (p < 0.0001), condyle resection (p = 0.001), and peripheral vascular disease (p = 0.035). Complication rates were similar between the cohorts (p > 0.05). Bony flaps scored higher on multiple FACE-Q scales: Facial Appearance (p = 0.023) Eating/Drinking (p = 0.029), Smiling (p = 0.012), Speaking (p < 0.001), Swallowing (p = 0.012), Smiling Distress (p = 0.037), and Speaking Distress (p = 0.001). Conclusion: Reconstruction of posterolateral mandibular defects has a similar complication profile when utilizing a bony or soft tissue free flap. Bony flaps may perform better with respect to PROMs. Reconstructive surgeons should consider using bony flap reconstruction to achieve higher patient satisfaction and quality of life. © 2023 Wiley Periodicals LLC. |
| Keywords: | adult; middle aged; retrospective studies; major clinical study; plastic surgery; fistula; quality of life; health survey; retrospective study; eating; graft failure; peripheral vascular disease; distress syndrome; surgery; complications; patient reported outcome measures; free tissue graft; hematoma; seroma; wound infection; wound healing impairment; soft tissue defect; wound dehiscence; osteoradionecrosis; speech; mandible; cellulitis; mandible reconstruction; swallowing; abscess; free flap; patient-reported outcome; free tissue flaps; patient reported outcomes; facial expression; head and neck reconstruction; drinking; humans; human; male; female; article; face-q; plastic surgery procedures; mandibulectomy; vestibuloplasty |
| Journal Title: | Journal of Surgical Oncology |
| Volume: | 129 |
| Issue: | 3 |
| ISSN: | 0022-4790 |
| Publisher: | Wiley Blackwell |
| Date Published: | 2024-03-01 |
| Start Page: | 617 |
| End Page: | 628 |
| Language: | English |
| DOI: | 10.1002/jso.27520 |
| PUBMED: | 37985365 |
| PROVIDER: | scopus |
| PMCID: | PMC11457306 |
| DOI/URL: | |
| Notes: | Article -- MSK corresponding author is Robert J. Allen Jr -- Source: Scopus |
