Functional results and quality of life after oral cavity reconstruction using autografts

Abstract

The purpose of the study was to conduct a comparative analysis and evaluate the functional results and quality of life of patients with head and neck cancer after radical surgery, depending on the reconstruction techniques used and the feasibility of using autografts for the repair of tissue innervation. Material and Methods. From 2014 to 2021a total of 133 patients with oral cavity cancer underwent simultaneous or delayed reconstruction after radical surgery at Clinical Hospital 1 of Sechenov University. All patients were divided into 4 groups: group 1 (n=37, the main group): reconstruction with free flaps “with reinnervation”, group 2 (n=24): reconstruction with free flaps “without reinnervation”, group 3 (n=23): reconstruction with pedicled axial flaps “with innervation”, and group 4 (n=49): reconstruction with pedicled axial flaps “without innervation”. The QLQ-H&N43 questionnaire was taken as the main tool, speech and swallowing functions were assessed by using scales, and sensibility was assessed by the Semmes-Weinstein and Weber tests, as well as by pain and temperature sensation. Results. In the main group, statistically significant best results were achieved in the following main scales of the QLQ-H&N43 questionnaire: total score - Me=21 (Q1-9; Q3-29) (p=0.038); speech -Me=27 (Q1-7; Q3-37) (p=0.05) and body image - Me=22 (Q1-0; Q3-47) (p=0.049). In group 1, significantly better results were obtained in assessing all sensory tests, except for the temperature sensation. In relation to less discomfort on the donor area and greater satisfaction with the cosmetic result, group 1 also gained better scores than other groups. Conclusion. The use of innervated flaps improves the quality of life and patient satisfaction with the treatment results in long-term follow-up.