Prosthetic intervention in the era of microvascular reconstruction of the mandible--a retrospective analysis of functional outcome.
Prosthetic intervention in the era of microvascular reconstruction of the mandible--a retrospective analysis of functional outcome.
复制标题
下颌骨微血管重建时代的假体介入——功能结果的回顾性分析。
DOI：
--
复制
发表时间：
2005
影响因子：
2.3
通讯作者：
I. Zlotolow
中科院分区：
文献类型：
--
作者：
K. Teoh;Snehal Patel;F. Hwang;J. Huryn;D. Verbel;I. Zlotolow
目的
这项回顾性研究的目的是比较下颌骨切除和重建伴和不伴假体干预的患者的功能结局，并确定可能对功能结局产生影响的预测因素。
材料和方法
220例接受下颌骨切除和重建的头颈部癌症患者，术后恢复至少6个月，构成了这项回顾性研究的基础。未接受假体干预的患者组成I组（n = 142）;接受假体干预的患者组成II组（n = 78）。使用四项单独评估（营养状况、吞咽、咀嚼性能和言语）和一项结合这些评估信息的功能结果总体指标（GMFO）来测量功能结果。统计分析用于比较I组和II组之间的基线特征和功能结局，并分析GMFO的独立预测因子。
结果
在回顾的220例患者中，78例（35%）接受了假体干预;第II组患者的个体功能结局指标和GMFO更好。在控制了其他重要的预测因素后，假体的使用仍然与GMFO相关;其他独立的预测因素包括口干症、剩余下颌牙数、牙与牙接触数、重建类型、皮瓣干扰和舌缺损。下颌牙较少的患者接受较小的修复体比接受较大修复体的患者具有更好的总体结果。
结论
下颌骨重建后接受修复干预的患者的功能结局明显优于未接受修复干预的患者，即使在调整混杂变量后也是如此。
PURPOSE
The purpose of this retrospective study was to compare the functional outcomes of patients who had mandibular resection and reconstruction with and without prosthetic intervention, and to identify predictive factors that may have an impact on functional outcomes.
MATERIALS AND METHODS
Two hundred twenty head and neck cancer patients who had undergone mandibular resection and reconstruction with at least 6 months of postoperative convalescence formed the basis of this retrospective review. Patients who did not receive prosthetic intervention formed group I (n = 142); those who received prosthetic intervention formed group II (n = 78). Functional outcomes were measured using four individual assessments (nutritional status, swallowing, masticatory performance, and speech) and one that combined the information from these assessments, the global measure of functional outcome (GMFO). Statistical analyses were used to compare the baseline characteristics and functional outcome between groups I and II and to analyze independent predictors for GMFO.
RESULTS
Of the 220 patients reviewed, 78 (35%) had prosthetic intervention; group II patients had better individual functional outcome measures and GMFO. Use of a prosthesis remained associated with GMFO after controlling for other significant predictors; other independent predictors were xerostomia, number of remaining mandibular teeth, number of tooth-to-tooth contacts, type of reconstruction, flap interference, and tongue defect. Patients who had fewer mandibular teeth and received a smaller prosthesis had better overall outcome than patients who received a larger prosthesis.
CONCLUSION
Patients who had prosthetic intervention after mandibular reconstruction had significantly better functional outcomes than patients who did not receive prosthetic intervention, even after adjusting for confounding variables.