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ITALIAN JOURNAL OF MAXILLOFACIAL SURGERY
Rivista di Chirurgia Maxillo-Facciale
Official Journal of the Italian Society of Maxillofacial Surgery
Italian Journal of Maxillofacial Surgery 2011 April;22(1):35-46
Oral rehabilitation of head and neck cancer patients: a systematic review and meta-analysis
Brauner E., Pompa G., Mauro V., Di Carlo S., Valentini V., Iannetti G.
Maxillo-Facial Department, La Sapienza University of Rome, Rome, Italy
AIM AND METHODS: Patients with carcinoma of the head and neck do not only have to face a life-threatening disease, but they also have to deal with the impact of both the disease and its treatment on their physical, psychological and social functioning. Patients suffering from oral cancer experience a negative change in their health-related quality of life (HRQoL). The complexity of rehabilitation in postoncological patients is attributable to the great diversity between cases that results from the anatomical and functional alterations effected by the surgical procedures required, the primary purpose of which is, of course, oncological radicality, the functional and aesthetic aspects are neglected. The lack of attention to functional and esthetic parameters is mostly attributable to the lack of interdisciplinary skills among most specialists. In fact, the patient’s classification is often conducted after the surgery because of the urgency involved in radicalizing the pathology. Several classifications have been proposed by various authors on the rehabilitation of postoncological patients. These classifications are detailed, but comparisons are difficult and do not include information about the reconstructive techniques and the rehabilitative outcomes. For a better evaluation of the results, a standardized concept of surgical and prosthodontic treatment is necessary. The aim of this review was to use a retrospective study of previous publications to develop a multidisciplinary treatment protocol for head and neck cancer patients from the time of diagnosis, through the surgery stage, to oral rehabilitation, and finally functional outcomes and (HRQoL) results. The authors focused our review on the correlation between the anatomically resected part and the choice of rehabilitation, including 889 patients.
RESULTS: Of the 889 patients, only 536 (60.29%) achieved final rehabilitation. Only 116 patients underwent surgery for the upper maxilla, while 660 were treated for the mandible. The treatment steps for the remaining 113 patients were not specified.
CONCLUSION:Future studies on the type of the surgical and rehabilitative outcome should be reported besides functional result and assessment of HRQoL of head and neck cancer.