Health-related quality of life after segmental resection of the lateral mandible: Free fibula flap versus plate reconstruction.
OBJECTIVE
Segmental resection of the mandible causes functional, aesthetic and social problems affecting health-related quality of life (HRQoL). It is often assumed that reconstruction with composite free flaps guarantees better function and aesthetics than bridging the defect with reconstruction plates.


METHODS
Using the European Organization for Research and Treatment of Cancer questionnaires (EORTC QLQ-C30 version 3.0 and EORTC QLQ-H&N35), we compared HRQoL in patients who received free fibula flaps versus reconstruction plates after segmental resection of the lateral mandible.


RESULTS
Thirty-seven completed questionnaires (18 fibula reconstructions and 19 patients with reconstruction plates) were available. Reconstruction with a free fibula flap did not provide clear additional benefit to bridging the defect with a reconstruction plate after segmental resection of the lateral mandible. In particular aspects known to have the most impact on HRQoL like swallowing, speech and chewing were not influenced by the type of reconstruction.


CONCLUSIONS
Reconstruction of segmental defects of the lateral mandible with free fibula flap and reconstruction plate resulted in comparable HRQoL. If dental rehabilitation by means of dental implants is not anticipated in the fibula, then plate reconstruction with adequate soft tissue remains a suitable technique for the reconstruction of segmental defects of the lateral mandible.
Department of Oral and Maxillofacial Surgery (Head: Ron Koole MD, DMD, PhD), University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands. Electronic address: j.t.m.vangemert@umcutrecht.nl.
Johannes
J
van Gemert
Department of Oral and Maxillofacial Surgery (Head: Ron Koole MD, DMD, PhD), University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
Irene
I
Holtslag
Department of Oral and Maxillofacial Surgery (Head: Ron Koole MD, DMD, PhD), University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
Andries
A
van der Bilt
Department of Oral and Maxillofacial Surgery (Head: Stefan Bergé MD, DMD, PhD), Radboud University Nijmegen Medical Centre, Geert Grooteplein-Zuid 10, 6525 GA Nijmegen, The Netherlands.
Matthias
M
Merkx
Department of Oral and Maxillofacial Surgery (Head: Ron Koole MD, DMD, PhD), University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
Ron
R
Koole
Department of Oral and Maxillofacial Surgery (Head: Ron Koole MD, DMD, PhD), University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
Ellen
E
Van Cann
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates / Q000523:psychology*; D016025:Bone Transplantation / Q000523:psychology*; D003679:Deglutition / Q000502:physiology; D004435:Eating / Q000502:physiology; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D058752:Free Tissue Flaps / Q000637:transplantation*; D006801:Humans; D008297:Male; D008334:Mandible / Q000502:physiology; D008339:Mandibular Neoplasms / Q000601:surgery; D063175:Mandibular Reconstruction / Q000295:instrumentation / Q000379:methods / Q000523:psychology*; D008409:Mastication / Q000502:physiology; D008875:Middle Aged; D037981:Neck Dissection / Q000523:psychology; D011788:Quality of Life; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D013060:Speech / Q000502:physiology
Mandible reconstruction; Mandible resection; Oral cavity cancer; Quality of life