Functional evaluation of mandibular reconstruction with bone free flap. A GETTEC study

[en] Objectives: To assess the functional results of oromandibular reconstruction by free bone flap, in terms of swallowing, speech and esthetics. Materials and methods: A transverse multicenter study included 134 patients reconstructed by free bone flap between 1998 and 2016, with more than 6 months’ follow-up, in 9 centers. A standardized questionnaire collected data on patients and treatment. Study endpoints comprised: weight loss, mouth opening, gastrostomy dependence, type of feeding, and DHI score. The impact of patient baseline characteristics on these functional criteria was explored by uni/multivariate analysis. Results: Ninety of the 134 patients had cancer. Fibula flap was mainly used (80%). 94% of reconstructions were primary successes. 71% of patients had pre- or post-operative radiation therapy. 88% had less than 50% lingual resection. 97% recovered oral feeding. 89% had intelligible speech. 86% judged their esthetic appearance as good/average. 9% had dental prosthetic rehabilitation. Radiation therapy and extensive lingual resection significantly impacted swallowing function (P = 0.04 and P = 0.03, respectively). Radiation therapy and oropharyngeal extension significantly increased gastrostomy dependence (P = 0.04 and P = 0.02, respectively). Conclusion: Oromandibular reconstruction by free bone flap enabled return to oral feeding in most cases. More than 80% of patients were satisfied with their result in terms of speech and esthetics. However, the rate of dental rehabilitation was low and the rate of complications was high. © 2020

Disciplines :

Otolaryngology

Author, co-author :

Atallah, S.; Sorbonne Université, hôpital Tenon, Service d'ORL et Chirurgie Cervico-Faciale, AP-HP, 4, rue de la Chine, Paris, 75020, France

Bozec, A.; Centre Antoine Lacassagne, département d'ORL et de chirurgie carcinologique de la Tête et du Cou, 33, avenue de Valombrose, Nice, 06189, France

RANSY, Pierre ; Centre Hospitalier Universitaire de Liège - CHU > Autres Services Médicaux > Service d'ORL, d'audiophonologie et de chir. cervico-faciale

Davrou, J.; Université Picardie Jules-Verne, CHRU, service de chirurgie maxillo-faciale et stomatologie, Place Victor Pauchet, Amiens Cedex, 80054, France

Longis, J.; Clinique de chirurgie maxillo-faciale et stomatologie, CHU Hôtel-Dieu, 1, place Alexis-Ricordeau, Nantes, 44000, France

Humbert, M.; Service d'ORL, CHU Côte de Nacre/Centre François Baclesse, Service du Dr MY Louis, Caen, France

Brenet, E.; CHU de Reims, hôpital Robert Debré, Service ORL et Chirurgie Cervico-faciale, Reims, France

Schultz, P.; Service ORL et Chirurgie Cervico-Faciale, CHU Hautepierre, 1 Avenue Maline, Strasbourg, 67098, France

Damecourt, A.; Service d'ORL, CHU Gui de Chauliac, Montpellier, France

Lacau Saint Guily, J.; Sorbonne Université, hôpital Tenon, Service d'ORL et Chirurgie Cervico-Faciale, AP-HP, 4, rue de la Chine, Paris, 75020, France

Baujat, B.; Sorbonne Université, hôpital Tenon, Service d'ORL et Chirurgie Cervico-Faciale, AP-HP, 4, rue de la Chine, Paris, 75020, France

Language :

English

Title :

Functional evaluation of mandibular reconstruction with bone free flap. A GETTEC study

Publication date :

2020

Journal title :

European Annals of Otorhinolaryngology, Head and Neck Diseases

ISSN :

1879-7296

eISSN :

1879-730X

Publisher :

Elsevier Masson SAS

Peer reviewed :

Peer Reviewed verified by ORBi

Available on ORBi :

since 09 June 2021

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