Does Segmental Mandibulectomy Involving Critical Functional Sites Affect Quality of Life?

Woliansky, Jonathan; Green, Lorne; Sim, Felix

doi:10.1016/j.joms.2023.04.003

Cited by 5 publications

(2 citation statements)

References 9 publications

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“…These oral functions are greatly impaired by the loss of teeth, jawbone, and oral soft tissues, and most patients with oral tumors have severe trouble with mastication and bolus formation. In particular, segmental mandibulectomy causes anatomical distortion resulting in a functional deficit [ 1 ]. Radiotherapy to the oral cavity also reduces the secretory capacity of the salivary glands.…”

Section: Introductionmentioning

confidence: 99%

Texture Analysis of Food Samples Used for the Evaluation of Masticatory Function

Shikama,

Matsuyama,

Kobayashi

et al. 2024

Cureus

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Introduction Food questionnaire surveys are often used to evaluate masticatory function. In daily clinical practice in Japan, a survey is performed using a list of food groups suitable for the Japanese diet. The foods on the list were categorized into five food groups based on their mastication index. The patient's masticatory function is determined by the food groups that can be eaten. The masticatory index, which indicates chewability, was defined based on the percentage of 110 denture wearers who responded that they could eat food normally. A survey with this list is useful because of its simplicity; however, there is a lack of objective data on the physical properties of food samples. Consequently, to make the results of the food questionnaire survey more objective indicators, we performed a texture analysis of the food samples on the list. Methods We performed a texture analysis of 93 samples from 77 food items on the list. Compression tests were performed using a texture analyzer, and hardness, cohesiveness, adhesiveness, viscosity, and gumminess were calculated by a texture profile analysis. Results Even with the same ingredients, the results differed depending on the presence or absence of food skin, the direction of pressing (vertical or horizontal), cooking methods, and temperature differences. However, the masticatory index was negatively correlated with hardness (-0.4157, p<0.001) and gumminess which is determined as the product of hardness×cohesiveness (-0.4980, p<0.001). Conclusion This study suggests that the masticatory index indicating chewability may be related to the hardness and cohesiveness of food samples. Even for foods with the same hardness, the degree of difficulty in forming a food mass is expected to vary depending on differences in cohesiveness. Moreover, the presence or absence of food skin, the direction of food fibers, cooking methods, and temperature differences change the physical properties of the food. Therefore, the composition and structure of the foods or eating habits of patients should be taken into consideration when conducting a food questionnaire survey.

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Section: Introductionmentioning

confidence: 99%

Texture Analysis of Food Samples Used for the Evaluation of Masticatory Function

Shikama,

Matsuyama,

Kobayashi

et al. 2024

Cureus

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“…The gold standard treatment in patients with OSCC is represented by primary surgery, associated with adjuvant treatments in patients with risk factors [4]. Improvement in quality of life in OSCC survivors is a major clinical challenge, especially in cases of mandibular involvement [5], since segmental mandibulectomy and the subsequent reconstruction have a crucial role in terms of aesthetic and functional outcomes [6]. Different modalities for mandibular reconstruction have been reported but composite-free flaps are considered the best options and nowadays, a fibula-free flap is often the first choice [7].…”

Section: Introductionmentioning

confidence: 99%

Segmental Mandibulectomy and Mandibular Reconstruction with Fibula-Free Flap Using a 3D Template

Tatti,

Carta,

Bontempi

et al. 2024

JPM

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Introduction: The present study evaluates the influence of virtual surgical planning with a preoperative 3D resin model on aesthetic and functional outcomes in patients treated by segmental mandibulectomy and reconstruction with fibula-free flap for oral cancer. Methods: All consecutive patients who underwent segmental mandibulectomy and mandibular reconstruction with a fibula-free flap using a 3D template at our department from January 2021 to January 2023 were included in the study. “Patients control” were patients treated by reconstruction with a fibula-free flap without using a 3D template. Three-dimensional modeling was performed by converting from preoperative computed tomography to a stereolithography format to obtain the resin 3D models. Qualitative analysis of anatomical and aesthetic results consisted of the evaluation of the patients’ aesthetic and functional satisfaction and the symmetry of the mandibular contour observed at clinical examination. Quantitative analysis was based on the assessment of the accuracy and precision of the reconstruction by comparing preoperative and postoperative computed tomograms as objective indicators. Results: Seven patients (five males and two females, mean age of 65.1 years) were included in the study. All patients showed a symmetric mandibular contour based on the clinical examination. After recovery, six patients (85.7%) considered themselves aesthetically satisfied. The quantitative analysis (assessed in six/seven patients) showed that the mean difference between preoperative and postoperative intercondylar distance, intergonial angle distance, anteroposterior dimension, and gonial angle improved in the 3D template-assisted group. Conclusion: The 3D-printed template for mandibular reconstruction with microvascular fibula-free flap can improve aesthetic outcomes in comparison with standard approaches.

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Analysis of condylar positioning in the temporomandibular joint following mandibular reconstruction: Introduction of a new classification system and assessment of influencing factors on displacement

Holkom,

Sakran,

Zhao

et al. 2024

Head & Neck

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ObjectiveThis study investigates the unsatisfactory outcomes observed in mandibular reconstruction procedures attributed to improper condylar positioning in the Temporomandibular Joint. It also proposes a systematic classification for post‐reconstruction condylar positioning dissatisfaction.MethodsA retrospective analysis was conducted on 337 patients who underwent tumor removal and mandibular reconstruction with vascularized osteocutaneous flaps. Reconstruction techniques included conventional surgery (43.3%) and 3D technology‐guided procedures (56.7%). Evaluation utilized preoperative and postoperative CT scans to assess mandibular vertical ramus length (V) and condylar alignment in both sagittal (S) and coronal (C) planes. Accordingly, a classification system for condylar positioning was developed and abbreviated as VSC. It includes four classes: Class I, proper condylar reconstruction; Class II, short ramus length; Class III, one or two aspects of sagittal/coronal condylar positions dissatisfaction; and Class IV, two or three aspects dissatisfaction.ResultsThe overall success rate for condylar reconstruction was 85.16%. Though not statistically significant, the success rate was marginally higher in the 3D‐assisted group (85.86%) compared to the conventional group (84.25%). In terms of the VSC classification, the distribution of cases across Class I, II, III, and IV were 287, 4, 9, and 37 cases, respectively. Notably, condylar dislocation was significantly associated with the defect site, particularly the body and condyle (p < 0.001, OR = 49.734, 95% CI 12.995–190.342), and the number of reconstructed segments (p = 0.025, OR = 3.480, 95% CI 1.173–10.328).ConclusionThe findings highlight the importance of accurate reconstruction methods and reveal implications of the defect site and the number of reconstructed segments in condylar dislocation. Consequently, we propose a classification system to refine condylar positioning assessment and enhance surgical outcomes in mandibular reconstruction.

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Does Segmental Mandibulectomy Involving Critical Functional Sites Affect Quality of Life?

Cited by 5 publications

References 9 publications

Texture Analysis of Food Samples Used for the Evaluation of Masticatory Function

Texture Analysis of Food Samples Used for the Evaluation of Masticatory Function

Segmental Mandibulectomy and Mandibular Reconstruction with Fibula-Free Flap Using a 3D Template

Analysis of condylar positioning in the temporomandibular joint following mandibular reconstruction: Introduction of a new classification system and assessment of influencing factors on displacement

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