Abstract
There remains a paucity of evidence with regards to functional outcomes following
the reconstruction of segmental defects in the mandible. It is, however, well recognised
that oral rehabilitation following head and neck surgery is a driver of improved quality
of life outcomes. We present a prospective service review of functional outcomes of
a consecutive cohort of patients following segmental mandibulectomy and virtual surgical
planning (VSP) composite fibular free-flap reconstruction. Twenty-five patients, who
were identified as having a complete dataset with a minimum of 12 months’ follow up,
ultimately met the inclusion criteria. Validated functional outcome measures were
used primarily to assess speech, diet, and swallowing outcomes. The results demonstrate
a decline in both speech and swallowing outcomes at three months postoperatively,
with a decline of 37% in the Speech Handicap Index from the preoperative baseline,
and a decline of 35% in the MD Anderson Dysphagia Inventory score over the same period.
The MD Anderson Dysphagia Inventory score improved at 12 months, whereas the Speech
Handicap Index did not. Fundamentally a collaborative approach is required between
members of the multidisciplinary team (MDT) to enable optimal patient outcomes.
Keywords
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Article info
Publication history
Published online: January 02, 2023
Accepted:
November 15,
2022
Received in revised form:
November 11,
2022
Received:
August 11,
2022
Identification
Copyright
© 2022 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
