Assessment of fibula flap with flexor hallucis longus's effect on head &amp; neck tumor patients' quality of life and function of donor site

Ni, Youkang; Zhang, Xuedi; Zhang, Zhiqiang; Liang, Weidi; Zhao, Lina; Li, Zijia; Li, Siqi; Lu, Ping; Xu, Zhongfei; Dai, Wei; Duan, Weiyi; Tan, Xiaoheng; Sun, Changfu; Liu, Fa‐Yu

doi:10.1016/j.oraloncology.2019.104489

Cited by 11 publications

(20 citation statements)

References 53 publications

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“…The body mass index (BMI) in our study determined an average value of 24.3 kg/m², which is in the upper range of normal weight and it is similar to values from comparable studies [ 38 , 53 , 62 , 63 ]. For better comparability with other studies, we summarize our graft types to fibula grafts with skin (76%) and without skin island (24%).…”

Section: Discussionsupporting

confidence: 88%

“…There are alternatives to SEBT and FADI in comparable literature. The American Orthopedic Foot and Ankle Society’s index (AOFAS) and the 36-items short form (SF-36) are the most frequently described questionnaires, but they are not validated for populations with ankle instability [ 26 , 53 , 54 ]. In addition to the FADI, the Foot and Ankle Outcome Score (FAOS), and the Foot and Ankle Ability Measure (FAAM) also meet this requirement.…”

Section: Discussionmentioning

confidence: 99%

“…In the setting of primary wound closure, the average stay lasted 16 days, in the setting of a split skin graft 22 days. Only a few studies provide specific information on in-patient stays that fluctuate between 12 and 26 days [ 30 , 53 , 65 , 68 , 69 ].…”

Section: Discussionmentioning

confidence: 99%

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Donor-Site Morbidity after Fibula Transplantation in Head and Neck Tumor Patients: A Split-Leg Retrospective Study with Focus on Leg Stability and Quality of Life

Attia

Diefenbach

Schmermund

et al. 2020

Cancers

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The free fibula flap has been one of the most important microvascular grafts for orofacial reconstruction for more than 30 years. The complication rates at the donor-site reported in literature are considered to be low, but the published data vary greatly in some cases. In particular, restrictions in the stability and balance of the involved leg and their effects on the quality of life have been described very inconsistently to date. Therefore, this study mainly focuses on the stability and balance of the affected leg in a split-leg design. Between December 2014 and January 2018, out of 119 subjects who underwent mainly jaw ablative tumor surgery and reconstruction using a fibula flap, 68 subjects were examined for donor site morbidity. Besides reporting general types of complications, two specific test procedures were used. The Star Excursion Balance Test (SEBT) as a practical test for ankle function and the Foot and Ankle Disability Index (FADI) as a questionnaire in order to assess quality of life, depending on the lower leg function. SEBT revealed an average of 55.3 cm with the operated leg as the supporting leg, which corresponds to 95.5% of 57.9 cm achieved with the healthy leg as the supporting leg. An average FADI score of 89.4% was recorded. SEBT and FADI seem to be suitable methods of examination for subjects post fibular transplantation and pointed out minimal limitations of the involved legs in comparison to the unaffected legs. These limitations were clinically not relevant and they had minor influence on the subjects’ quality of life and their daily activities.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

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Donor-Site Morbidity after Fibula Transplantation in Head and Neck Tumor Patients: A Split-Leg Retrospective Study with Focus on Leg Stability and Quality of Life

Attia

Diefenbach

Schmermund

et al. 2020

Cancers

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“…Donor-site morbidity was even lower with FHL muscle harvest. 39 We presented a total of 85 patients with oropharyngeal cancer who underwent reconstruction with either osteocutaneous or osteomyocutaneous flaps. After following up patients for an average of 39.5 months, it was encouraging to note that muscle helped prevent the occurrence of ORN in this study population.…”

Section: Discussionmentioning

confidence: 99%

Osteomyocutaneous Free Fibula Flap Prevents Osteoradionecrosis and Osteomyelitis in Head and Neck Cancer Reconstruction

Wang

Liu

Chen

et al. 2021

J Reconstr Microsurg

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Background Osteoradionecrosis (ORN) is one of the most severe complications of free fibula reconstruction after radiotherapy. The gold standard treatment of osteomyelitis involves extensive debridement, antibiotics, and sufficiently vascularized muscle flap coverage for better circulation. Therefore, we hypothesized that free fibula flap with muscle could decrease the risk of ORN. Methods This study consisted of 85 patients who underwent reconstruction with free fibula flap in head and neck cancer by a single reconstructive surgeon at Kaohsiung Veterans General Hospital over a period of 19 years (1998–2016). Patients with postoperative adjuvant radiotherapy were included in the study and were grouped by either free fibula osteocutaneous flap or free fibula osteomyocutaneous flap (with flexor hallucis longus muscle), and the incidence of ORN was compared. Results Of the 85 patients, 15 were reconstructed with osteocutaneous fibula flap and 70 were with osteomyocutaneous fibula flap. The rate of ORN or osteomyelitis was significantly lower in the muscle group (18.6%, n = 13/70 vs. 46.7%, n = 7/15, p = 0.020, Chi-square test). Conclusion Vascularized muscle transfer increases perfusion of surrounding tissues and the bone flap, thereby decreasing the incidence of osteomyelitis or osteonecrosis.

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“…Several authors have evaluated the quality of life (QoL) and functional results in patients undergoing OFF flaps for mandible reconstruction [ 5 – 10 ]. Ni et al [ 5 ] found all the nine fields of the SF-36 questionnaire, including physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role-emotional, mental health, and reported health transition, had acceptable scores. Similar results are also reported by others [ 6 , 7 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Masticatory performance in patients undergoing free fibula flap for mandible reconstruction

et al. 2022

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Background To explore the masticatory performance in patients undergoing an osteo(cutaneous) free fibula (OFF) flap for mandible reconstruction by a prospective design. Methods A total of 56 patients who had undergone OFF flap reconstructions for mandibular reconstruction secondary to malignant (squamous cell carcinoma) or benign (ameloblastoma) tumor resection were prospectively enrolled. They were asked to complete the masticatory performance test by the weigh method and the chew domain of the University of Washington quality of life questionnaire (version 4) preoperatively and at 3, 6, and 12 months postoperatively. The pair nonparametric test was used to analyze the dynamic change of masticatory performance and subjective chew function. Results Fifty-one patients were included for analysis finally. The mean masticatory performance for patients with malignant tumors were 53.4% ± 10.3%, 36.4% ± 10.3%, 42.6% ± 9.6%, 52.8% ± 10.9%, and 53.1% ± 11.8% preoperatively, at 2 weeks, 3 months, 6 months, and 12 months postoperatively, respectively. Compared with the preoperative level, the masticatory performance had a significant reduction immediately after surgery (p < 0.001), followed by a return to the baseline level within three months. A similar trend was noted for those with benign tumors. The mean score of chew domain for patients with malignant tumors were 100 ± 0, 54.3 ± 32.9, 81.4 ± 24.5, and 92.9 ± 17.8 preoperatively, at 3 months, 6 months, and 12 months postoperatively, respectively. Compared with the preoperative level, the subjective chew function was greatly affected within the first three months (p < 0.001), and it gradually recovered to the baseline level in the following nine months. A similar trend was noted in patients with benign tumors. Conclusions The masticatory performance and subjective chew function was significantly affected after OFF flap reconstructions in the short term, but both recovered to the preoperative levels within 9–12 months.

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Assessment of fibula flap with flexor hallucis longus's effect on head & neck tumor patients' quality of life and function of donor site

Cited by 11 publications

References 53 publications

Donor-Site Morbidity after Fibula Transplantation in Head and Neck Tumor Patients: A Split-Leg Retrospective Study with Focus on Leg Stability and Quality of Life

Donor-Site Morbidity after Fibula Transplantation in Head and Neck Tumor Patients: A Split-Leg Retrospective Study with Focus on Leg Stability and Quality of Life

Osteomyocutaneous Free Fibula Flap Prevents Osteoradionecrosis and Osteomyelitis in Head and Neck Cancer Reconstruction

Masticatory performance in patients undergoing free fibula flap for mandible reconstruction

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