title: Health-related quality of life after treatment for neoplasia of the major salivary glands: a pilot study.
abstract: Treatment of malignancy of the salivary glands risks damage to the cranial nerves, and clinicians' traditional view has been that this will result in adverse effects on physical function and subsequent health-related quality of life (QoL). Preservation of nerves has been advocated to lessen this impact, but we know of no evidence that sacrifice of the facial nerve has any effect on subsequent QoL. We collected data prospectively before and after operation for all malignancies of the major salivary glands treated over five years using two health-related QoL questionnaires: the University of Washington Quality of Life Questionnaire and the Patient Concerns Inventory. Fifteen of17 eligible patients fulfilled the inclusion criteria by having assessments completed both before and after operation. Scores for QoL after treatment of cancer of the submandibular gland dropped at six months, but had resolved to more than 80% of the pretreatment score by a year, with the exception of the domains taste and saliva. The four patients who had weakness of the facial nerve after treatment had appreciable reductions in the physical function components of the QoL domains, but no significant reduction in the social-emotional domains. Use of the Patient Concerns Inventory enables tailoring of services towards those clinicians who a patient feels are potentially most likely to help alleviate factors that have an adverse effect on QoL. Sacrifice of the facial nerve in malignant parotid gland disease results in a considerable reduction in functional health-related QoL scores. Methods to ensure clearance of the tumour while limiting the effects on facial nerve function should always be considered.
authors.affiliation: Department of Oral and Maxillofacial Surgery, New Cross Hospital, Wolverhampton WV10 0QP, England; Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Birmingham Research Park, Birmingham B15 2SQ, England. Electronic address: johno.breeze@gmail.com.
authors.forename: J
authors.initials: J
authors.lastname: Breeze
authors.affiliation: Biostatistical Operations, Worldwide Clinical Trials, Isaac Newton Centre, Nottingham Science Park, Nottingham NG7 2RH, England.
authors.forename: A
authors.initials: A
authors.lastname: Morrison
authors.affiliation: Department of Oral and Maxillofacial Surgery, New Cross Hospital, Wolverhampton WV10 0QP, England.
authors.forename: D
authors.initials: D
authors.lastname: Dawson
authors.affiliation: Department of Oral and Maxillofacial Surgery, New Cross Hospital, Wolverhampton WV10 0QP, England.
authors.forename: J
authors.initials: J
authors.lastname: Tipper
authors.affiliation: Department of Oral and Maxillofacial Surgery, New Cross Hospital, Wolverhampton WV10 0QP, England.
authors.forename: K
authors.initials: K
authors.lastname: Rehman
authors.affiliation: Department of Oral and Maxillofacial Surgery, New Cross Hospital, Wolverhampton WV10 0QP, England.
authors.forename: N
authors.initials: N
authors.lastname: Grew
authors.affiliation: Department of Oral and Maxillofacial Surgery, New Cross Hospital, Wolverhampton WV10 0QP, England.
authors.forename: N
authors.initials: N
authors.lastname: Pigadas
mesh_terms: D020220:Facial Nerve Injuries / Q000209:etiology*; D006258:Head and Neck Neoplasms; D006801:Humans; D010865:Pilot Projects; D011446:Prospective Studies; D011788:Quality of Life; D012468:Salivary Gland Neoplasms / Q000601:surgery*; D012469:Salivary Glands; D011795:Surveys and Questionnaires
keywords: Cancer; Complication; Quality of Life; Salivary gland; Surgery