Timing of edentulation and extraction in the management of oral cavity and oropharyngeal malignancies.
BACKGROUND
Pretreatment dental evaluation is an essential element in the management of the head and neck cancer patient. Frequently, the dental condition requires edentulation or multiple extractions prior to radiotherapy. These extractions may be carried out at the time of oncologic resection. Such practice is routine for some surgeons but resisted by others who fear increased postoperative wound complications. To date, no study evaluating the safety and efficacy of extractions at the time of surgical resection has been reported. This paper retrospectively examines the postoperative course of head and neck cancer patients with varying strategies of dental management.


METHODS
Retrospective analysis of patients with surgically treated oral cavity or oropharyngeal malignancies and dental extractions or edentulation at a tertiary oncology center from 1985 to 1994 was made. Postoperative wound infection, fistula, and length of stay data were compared for patients undergoing concurrent extraction and those having dental extractions in the postoperative period.


RESULTS
Thirty-two patients underwent ablative resection with concurrent extraction, whereas 23 had postsurgical extractions. The infection and fistula rates were 16% and 9% in the concurrent group and 35% and 26% for patients having postsurgical extractions. Mean postoperative stays were significantly shorter for patients undergoing concurrent extraction (15 +/- 8 days) compared with those of the postsurgical group (27 +/- 14 days).


CONCLUSIONS
Patients whose extractions were performed concurrent with the oncologic resection experienced fewer postoperative wound complications and had significantly shorter postoperative hospitalizations than did the postsurgical group.
Doerr
T D
TD
Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA.
Marunick
M T
MT
D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000601:surgery*; D009066:Mouth, Edentulous; D009960:Oropharynx; D010610:Pharyngeal Neoplasms / Q000601:surgery*; D011183:Postoperative Complications; D012189:Retrospective Studies; D014081:Tooth Extraction / Q000379:methods*