Health-related quality of life in maxillectomy patients undergoing dentoalveolar rehabilitation

George A Petrides; Masako Dunn; Emma Charters; Rebecca Venchiarutti; Kai Cheng; Catriona Froggatt; Payal Mukherjee; Christine Wallace; Dale Howes; David Leinkram; Jasvir Singh; Kevin Nguyen; Tsu-Hui Hubert Low; Sydney Ch'ng; James Wykes; Jonathan R Clark

doi:10.1016/j.oraloncology.2022.105757

Health-related quality of life in maxillectomy patients undergoing dentoalveolar rehabilitation

Oral Oncol. 2022 Mar:126:105757. doi: 10.1016/j.oraloncology.2022.105757. Epub 2022 Feb 1.

Authors

Affiliations

¹ Sydney Head and Neck Cancer Institute, Department of Head and Neck Surgery, Chris O'Brien Lifehouse, 119-143 Missenden Road, Camperdown, NSW 2050, Australia.
² Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, Camperdown, NSW 2050, Australia.
³ Department of Oral Restorative Sciences, Westmead Centre for Oral Health, Corner of Hawkesbury Road and, Darcy Road, Westmead NSW 2145, Australia.
⁴ Sydney Head and Neck Cancer Institute, Department of Head and Neck Surgery, Chris O'Brien Lifehouse, 119-143 Missenden Road, Camperdown, NSW 2050, Australia; School of Dentistry, Faculty of Medicine and Health, University of Sydney, 2 Chalmers St, Surry Hills, NSW 2010, Australia.
⁵ Sydney Head and Neck Cancer Institute, Department of Head and Neck Surgery, Chris O'Brien Lifehouse, 119-143 Missenden Road, Camperdown, NSW 2050, Australia; Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Anderson Stuart Building, The University of Sydney, Camperdown, NSW 2050, Australia; Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia.
⁶ Sydney Head and Neck Cancer Institute, Department of Head and Neck Surgery, Chris O'Brien Lifehouse, 119-143 Missenden Road, Camperdown, NSW 2050, Australia; Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Anderson Stuart Building, The University of Sydney, Camperdown, NSW 2050, Australia; Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, Camperdown, NSW 2050, Australia; Department of Plastic Surgery, Royal Prince Alfred Hospital, 50 Missenden Rd, Camperdown, NSW 2050, Australia.
⁷ Sydney Head and Neck Cancer Institute, Department of Head and Neck Surgery, Chris O'Brien Lifehouse, 119-143 Missenden Road, Camperdown, NSW 2050, Australia; Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Anderson Stuart Building, The University of Sydney, Camperdown, NSW 2050, Australia.
⁸ Sydney Head and Neck Cancer Institute, Department of Head and Neck Surgery, Chris O'Brien Lifehouse, 119-143 Missenden Road, Camperdown, NSW 2050, Australia; Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Anderson Stuart Building, The University of Sydney, Camperdown, NSW 2050, Australia; Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, Camperdown, NSW 2050, Australia. Electronic address: [email protected].

PMID: 35121398
DOI: 10.1016/j.oraloncology.2022.105757

Abstract

Objectives: Surgical resection of the maxilla impairs aesthetics, speech, swallowing, and mastication. Maxillary reconstruction is increasingly performed with virtual surgical planning (VSP) to enhance functional dental rehabilitation with a conventional denture or osseointegrated implants. The aim of this study was to determine whether dental status and VSP is associated with health-related quality of life (HRQOL) and function in patients who have undergone maxillectomy.

Materials and methods: A cross-sectional study was conducted among patients who underwent free flap reconstruction or obturation of the maxilla between July 2009 and December 2020. The FACE-Q Head and Neck Cancer (FACE-Q) module, M.D. Anderson Dysphagia Inventory (MDADI), and Speech Handicap Index (SHI) were used to evaluate HRQOL.

Results: Forty-three patients (response rate 59%) completed questionnaires and 48% underwent dental rehabilitation. In Okay Class II and III defects, adjusting for the effect of radiotherapy and time from surgery, there was a positive association between denture status and FACE-Q smiling (p = 0.020), eating (p = 0.012), smiling (p = 0.015), and MDADI global (p = 0.015), emotional (p = 0.027), functional (p = 0.028), and composite (p = 0.029) scores. VSP was associated with FACE-Q swallowing (p = 0.005), drooling (p = 0.030), eating (p = 0.008), smiling (p = 0.021), MDADI global (p = 0.017), emotional (p = 0.041), functional (p = 0.040), composite (p = 0.038), and SHI total scores (p = 0.042).

Conclusions: Dentoalveolar rehabilitation and VSP were associated with higher HRQOL scores relating to eating and drinking, smiling, and speaking.

Keywords: Dental implants; Head and Neck cancer; Maxilla; Mouth rehabilitation; Oral cancer; Quality of life; Surgical reconstruction.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Cross-Sectional Studies
Deglutition
Deglutition Disorders*
Humans
Plastic Surgery Procedures*
Quality of Life