Quality of Life Assessment for Intraoral Reconstruction

Svrha istraživanja bila je usporediti tri najčešće upotrebljavane metode rekonstrukcije usne šupljine na našoj Klinici nakon resekcije intraoralnog karcinoma. Uspoređivani su lokalni režnjevi (jezični i nazolabijalni), regionalni pektoralis major i slobodni podlaktični režanj. Uspoređivane tri skupine bolesnika nisu se razlikovale u stadiju bolesti. Za ocjenu uspješnosti rekonstrukcije kreiran je klinički upitnik od dva dijela. Prvi dio kliničkog upitnika sadrži opće podatke o bolesniku te podatke o tumoru. Drugi dio kliničkog upitnika sastoji se od ciljanih pitanja o postoperativnim funkcijskim i estetskim rezultatima. Osim usporedbe triju metoda rekonstrukcije istražili smo o kojim parametrima općenito ovisi uspjeh rekonstrukcije te utječe li rekonstrukcija na postoperativnu kakvoću života i na koji način. Raščlamba dobivenih podataka pokazala je da ni jedna od triju metoda rekonstrukcije nije superiornija u svim parametrima od preostalih dviju metoda. Slobodni podlaktični režanj nije statistički znatno pokazao očekivane teoretske prednosti pred regionalnim pektoralis major režnjem, iako je u gotovo svim parametrima bolje bodovan. Stadij bolesti i opseg resekcije bitni su parametri za postoperativne rezultate rekonstrukcije neovisno o tipu režnja.The aim of the investigation was to compare the three most commonly used methods of reconstruction of the oral cavity in the University Hospital “Dubrava”, after resection of intraoral carcinoma. In a group of 50 patients, with no statistically significant differences with regard to the stage of disease, local flaps (19 patients), regional pectoralis major flap (11 patients) and free forearm flap (20 patients) were compared. A clinical questionnaire was prepared for evaluation of the success of reconstruction, consisting of two parts. The first part of the questionnaire contained general information on the patient and data on the tumour. The second part of the questionnaire consisted of questions on postoperative functional and aesthetic results. Apart from comparison of the three methods of reconstruction, we also investigated on a sample of 55 patients which parameters were most important for the success of the reconstruction and whether and in what way reconstruction has an effect on postoperative quality of life on a sample of 55 patients. Analysis of the obtained data indicated that none of the three methods of reconstruction were superior in all parameters compared to the other two methods. Free forearm flap did not statistically significantly show the expected theoretic advantage over the regional pectoralis major flap, although it scored higher in almost all parameters. The stage of the disease and extent of resection are the most significant parameters for postoperative result of reconstruction, regardless of the type of flap