title: Predictive factors for functional recovery after free tissue transfer oromandibular reconstruction.
abstract: BACKGROUND
  Recovery of upper aerodigestive tract function after reconstruction of segmental oromandiblectomy defects is frequently incomplete. The purpose of this study was to quantitate postreconstruction function and define variables that predict functional outcome in this population.
  
  
  METHODS
  A prospective study of 21 patients who underwent microvascular free tissue transfer reconstruction of segmental oromandibular defects was performed. Measures of swallowing, speech, bite, and oral intake were performed preoperatively and at 1, 3, 6, and 12 months postoperatively or until plateau. Preoperative versus maximal postoperative measures were compared and correlated with nine potentially predictive variables. Univariate and multivariate analyses were performed to determine the most significant predictive factors.
  
  
  RESULTS
  Baseline function in the study population was abnormal. Postoperative bite force improved, but swallowing, speech, and oral intake were worse than preoperative. Significant (univariate) predictors of outcome included diagnosis of cancer, tongue resection, pharynx resection, and flap skin paddle area. Only tongue resection remained significant in multivariate analysis.
  
  
  CONCLUSIONS
  Increasing need for oropharyngeal lining replacement, especially after tongue resection, is the most important predictor of functional outcome in reconstruction of segmental mandible defects.
authors.affiliation: Department of Surgery, Indiana University Medical Center, Indianapolis, USA.
authors.forename: J D
authors.initials: JD
authors.lastname: Wagner
authors.forename: J J
authors.initials: JJ
authors.lastname: Coleman
authors.forename: E
authors.initials: E
authors.lastname: Weisberger
authors.forename: P D
authors.initials: PD
authors.lastname: Righi
authors.forename: S
authors.initials: S
authors.lastname: Radpour
authors.forename: S
authors.initials: S
authors.lastname: McGarvey
authors.forename: A
authors.initials: A
authors.lastname: Bayler
authors.forename: J
authors.initials: J
authors.lastname: Chen
authors.forename: H
authors.initials: H
authors.lastname: Crow
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001732:Bite Force; D003679:Deglutition; D004435:Eating; D005260:Female; D006801:Humans; D008297:Male; D008334:Mandible / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D009055:Mouth / Q000473:pathology / Q000601:surgery*; D009062:Mouth Neoplasms / Q000473:pathology / Q000601:surgery; D009960:Oropharynx / Q000473:pathology / Q000601:surgery; D011379:Prognosis; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000534:rehabilitation*; D013060:Speech; D013524:Surgical Flaps; D014059:Tongue / Q000473:pathology / Q000601:surgery; D014945:Wound Healing