Microvascular Reconstruction of Osteonecrosis: Assessment of Long-term Quality of Life.
Otolaryngol Head Neck Surg
; 165(5): 636-646, 2021 11.
Article
em En
| MEDLINE
| ID: mdl-33618563
ABSTRACT
OBJECTIVE:
Review long-term clinical and quality-of-life outcomes following free flap reconstruction for osteonecrosis. STUDYDESIGN:
Retrospective multi-institutional review.SETTING:
Tertiary care centers.METHODS:
Patients included those undergoing free flap reconstructions for osteonecrosis of the head and neck (N = 232). Data included demographics, defect, donor site, radiation history, perioperative management, diet status, recurrence rates, and long-term quality-of-life outcomes. Quality-of-life outcomes were measured using the University of Washington Quality of Life (UW-QOL) survey.RESULTS:
Overall flap success rate was 91% (n = 212). Relative to preoperative diet, 15% reported improved diet function at 3 months following reconstruction and 26% at 5 years. Osteonecrosis recurred in 14% of patients (32/232); median time to onset was 11 months. Cancer recurrence occurred in 13% of patients (29/232); median time to onset was 34 months. Results from the UW-QOL questionnaire were as follows no pain (45%), minor or no change in appearance (69%), return to baseline endurance level (37%), no limitations in recreation (40%), no changes in swallowing following reconstruction (28%), minor or no limitations in mastication (29%), minor or no speech difficulties (93%), no changes in shoulder function (84%), normal taste function (19%), normal saliva production (27%), generally excellent mood (44%), and no or minimal anxiety about cancer (94%).CONCLUSION:
The majority of patients maintained or had advancement in diet following reconstruction, with low rates of osteonecrosis or cancer recurrence and above-average scores on UW-QOL survey suggesting good return of function and quality of life.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Osteonecrose
/
Qualidade de Vida
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Doenças Maxilomandibulares
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Procedimentos de Cirurgia Plástica
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Retalhos de Tecido Biológico
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Osteonecrose da Arcada Osseodentária Associada a Difosfonatos
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Aspecto:
Patient_preference
Limite:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Otolaryngol Head Neck Surg
Ano de publicação:
2021
Tipo de documento:
Article