Background
Maxillary defects subsequent to hemimaxillectomy have long been restored with a pedicled temporalis flap. Recently,the trend towards maxillary reconstruction using vascularized bone free flaps and soft tissue free flaps has been gaining popularity. However, the value in terms of functional rehabilitation of these surgical modalities remains unconclusive.
Objective
To ascertain and compare masticatory performance and quality-of-life in patients with surgically reconstructed maxillectomy Class 2 (subtype A) defects by vascularized bone free flaps, vascularized soft tissue free flaps and pedicled soft tissue flaps.
Methods
Eighteen patients divided into 3 groups (4 vascularized bone flap, 5 vascularized soft tissue flap, 9 pedicled soft tissue flaps) were evaluated for functional outcome and qualityof-life (QoL). All patients were objectively assessed using masticatory comminution test. Subjective evaluation was conducted using functional outcomes questionnaire and patient reported speech perception. Self image and body perception were assessed using Body Esteem Scale. Overall quality-of-life was assessed using University of Washington QoL questionnaires.
Results
Patients reconstructed with vascularized bone flaps and vascularized soft tissue flaps showed superior masticatory performance compared to patients reconstructed with pedicled soft tissue flaps. Speech, facial attractiveness and overall QoL were similar for all three groups.
Conclusions
Maxillectomy class 2 (subtype A) patients show comparable speech, facial attractiveness and quality-of-life levels after reconstruction with vascularized bone flaps, vascularized soft tissue flaps and pedicled soft tissue flaps. However, those reconstructed with pedicled soft tissue flaps achieved lowest masticatory performances amongst the three surgical reconstruction modalities. Thus, the choice of recontruction for maxillectomy class 2 (subtype A) defects should be guided by minimizing surgical time and long term morbidity given the apparent similarity in functional outcomes. / published_or_final_version / Dental Surgery / Master / Master of Dental Surgery
| Identifer | oai:union.ndltd.org:HKU/oai:hub.hku.hk:10722/180082 |
| Date | January 2012 |
| Creators | Loo, Sun Din., 羅山定. |
| Publisher | The University of Hong Kong (Pokfulam, Hong Kong) |
| Source Sets | Hong Kong University Theses |
| Language | English |
| Detected Language | English |
| Type | PG_Thesis |
| Source | http://hub.hku.hk/bib/B48541941 |
| Rights | The author retains all proprietary rights, (such as patent rights) and the right to use in future works., Creative Commons: Attribution 3.0 Hong Kong License |
| Relation | HKU Theses Online (HKUTO) |
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