title: Facial appearance after operations for oral and oropharyngeal cancer: a comparison of casenotes and patient-completed questionnaire.
abstract: Disfigurement after operations for oral and oropharyngeal cancer is an important issue. Our aim was to review the casenotes of patients who reported distress in the appearance domain of the University of Washington Quality of Life Scale (UWQOL) and to find out what help they were given. Of 278 patients with previously untreated oral and oropharyngeal squamous cell carcinoma treated between 1995 and 1999, 114 (41%) were concerned about their appearance. Factors that correlated with these concerns included tumours more than 2cm in size, T2 or worse stage, free tissue reconstruction, segmental mandibular resection, and neck dissection. In only 7 of the 114 was there any mention of the patient's appearance in the clinic notes, of whom 4 were given help (2 scar revisions and 2 oral rehabilitations). This study suggests that patients' concerns about disfigurement are poorly recognised in routine clinical practice and supports the principle of using the UWQOL scale to discuss problems of appearance with patients.
authors.affiliation: Pembroke Place, Liverpool University Dental Hospital, Liverpool, UK. millsopp@liv.ac.uk
authors.forename: Lynne
authors.initials: L
authors.lastname: Millsopp
authors.forename: Louise
authors.initials: L
authors.lastname: Brandom
authors.forename: Gerry
authors.initials: G
authors.lastname: Humphris
authors.forename: Derek
authors.initials: D
authors.lastname: Lowe
authors.forename: C
authors.initials: C
authors.lastname: Stat
authors.forename: Simon
authors.initials: S
authors.lastname: Rogers
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001828:Body Image; D002294:Carcinoma, Squamous Cell / Q000523:psychology / Q000601:surgery*; D016009:Chi-Square Distribution; D005145:Face / Q000033:anatomy & histology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000523:psychology / Q000601:surgery*; D009959:Oropharyngeal Neoplasms / Q000523:psychology / Q000601:surgery*; D017060:Patient Satisfaction; D011788:Quality of Life; D019651:Plastic Surgery Procedures / Q000706:statistics & numerical data; D012917:Social Adjustment; D011795:Surveys and Questionnaires