Functional outcomes after primary mandibular resection and reconstruction with the fibular free flap.
OBJECTIVE
This study examined prospectively the functional outcomes of a cohort of patients who have undergone mandibulectomy and primary fibular free flap reconstruction, with particular emphasis on longitudinal comparison of the preoperative function with that in the postoperative and post-radiation therapy time periods.


METHODS
Speech and swallowing data were gathered at three evaluation times (preoperatively, pre-radiation therapy, and post-radiation therapy) for patients treated for oral cavity cancer with mandibular resection and reconstruction with a fibular free flap. Single words and sentences were recorded and analyzed for speech intelligibility. Modified barium swallows of liquid, pudding, and cookie consistencies were analyzed and graded for problems in the oral preparatory and oral phase according to the University of Chicago Center for Speech and Swallowing Disorders Oropharyngeal Mobility Data Form.


RESULTS
There was no significant difference across any of the evaluation times for single-word or sentence intelligibility. The swallowing data showed no instances of post-treatment aspiration or laryngeal penetration. There were also no significant differences in any of the swallowing parameters across treatment times.


CONCLUSIONS
Osteocutaneous fibular free flaps are an excellent reconstructive option for mandibular and floor of the mouth defects.
Seikaly
Hadi
H
Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta.
Maharaj
Mitra
M
Rieger
Jana
J
Harris
Jeff
J
D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003680:Deglutition Disorders / Q000175:diagnosis / Q000209:etiology; D005360:Fibula / Q000637:transplantation*; D005500:Follow-Up Studies; D006801:Humans; D008334:Mandible / Q000473:pathology* / Q000528:radiation effects / Q000601:surgery*; D008875:Middle Aged; D009060:Mouth Floor / Q000473:pathology / Q000528:radiation effects / Q000601:surgery; D009062:Mouth Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D009367:Neoplasm Staging; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods*; D013065:Speech Intelligibility; D013068:Speech Production Measurement; D013524:Surgical Flaps; D016896:Treatment Outcome