PDF(Pubmed)
Abstract：
Background: Virtual surgical planning has become a well-established practice in head and neck surgery. In oncological surgery, it permits the achievement of safe margins resections and ensures functional reconstructions and optimal esthetic outcomes. This study aimed to evaluate the long-term outcomes after virtually planned mandibular microvascular reconstruction, focusing on functional and esthetic results, as well as health-related quality of life. Methods: A long-term retrospective evaluation of 17 patients with oral cavity malignancy who underwent computer-assisted mandibular resection and reconstruction was performed. Functional and esthetic outcomes were analyzed using the EORTC, QLQ-C30, H&N35, and FACE-Q questionnaires. Results: Time since reconstruction ranged from 7 to 14 years. Patients reported high functional levels on the QLQ-C30 functional scales but lower scores on H&N35. On FACE-Q, patients demonstrated higher appraisal and satisfaction with their smiles compared to their overall facial appearance. Conclusions: In this retrospective case series, patients undergoing computer-assisted mandibular reconstruction for oral malignancies achieved good long-term functional and esthetic outcomes. Although limited by the small sample size, these results support the enduring benefits of virtual planning for mandibular reconstruction. To minimize declines in function and appearance, considerations should include immediate dental implants, enhanced reconstruction of the temporomandibular joint, newer methods of radiotherapy to minimize xerostomia, and oral exercises to prevent trismus.
摘要：
背景：虚拟手术计划已成为头颈部手术中公认的做法。在肿瘤外科手术中，它允许实现安全的边缘切除，并确保功能重建和最佳的美学结果。本研究旨在评估几乎有计划的下颌微血管重建后的长期结果。专注于功能和美学结果，以及与健康相关的生活质量。方法：对17例接受计算机辅助下颌骨切除重建的口腔恶性肿瘤患者进行长期回顾性评估。使用EORTC分析功能和美学结果，QLQ-C30、H&N35和FACE-Q问卷。结果：自重建以来的时间为7至14年。患者在QLQ-C30功能量表上报告了较高的功能水平，但在H＆N35上得分较低。在Face-Q上,与整体面部外观相比，患者对微笑的评价和满意度更高。结论：在这个回顾性病例系列中，接受计算机辅助下颌骨重建治疗口腔恶性肿瘤的患者获得了良好的长期功能和美学结果.尽管受到样本量小的限制，这些结果支持了下颌骨重建虚拟计划的持久益处.为了尽量减少功能和外观的下降，考虑因素应包括立即种植牙，增强颞下颌关节的重建，新的放射治疗方法来减少口干症，和口腔锻炼来预防牙关。
