ABSTRACT
Mandibular resections decision is one of the most important steps in oral cavity malignant or nonmalignant lesions associated with the mandible. The role of mandibular reconstruction is not only for cosmesis, but it is also indicated for functional rehabilitation such as swallowing, phonetics, and for facial symmetrical. Even though the free tissue transfer is considered a gold standard for mandibular reconstruction, the importance of nonvascularized bone grafts (NVBGs) such as fibula, calvarium, rib, sternum, and iliac are still persisting in mandibulectomies condition like patient who have not taken radiotherapy or not willing to undergo radiotherapy or not fit for free tissue transfer and provides a good contour of mandibular replacement. The success rate of NVBG depends upon patient selection, preoperative planning, and meticulous nursing care. Addition to NVBG, regional flaps such as pectoralis major myocutaneous (PMMC) flap will help in soft-tissue replacement of the defect as well as it will help in the situation where primary closure and airtight closure is not possible. This case report will discuss in detail about the management of anterior segmental mandibulectomy due to oncological resection and reconstruction with NVBG with fibula and PMMC.
ABSTRACT
BACKGROUND: The modern-day onco-surgical therapy is now concerned on the overall Quality of Life after treatment of the patient. There is need to evaluate final outcome following the different combination of treatment modalities available to make better therapeutic treatment decisions. AIM: The aim of this study was to assess Oral health related quality of life (OHRQoL) in patients with oral malignancies who had undergone various treatments. SETTINGS AND DESIGN: A Cross sectional study was conducted among 90 patients between October 2016 to January 2017 in private hospitals, kanchipuram, India. MATERIALS AND METHODS: Participants were grouped based on the treatment they had undergone into Group I - Surgery alone, Group II - Surgery and Radiotherapy, Group III- Surgery, chemotherapy and radiotherapy and assessed for OHRQoL using the shorter version of Oral health impact profile -14 (OHIP-14) questionnaire. STATISTICAL ANALYSIS: Descriptive analysis of socio demographic variables and OHIP 14 was performed using Chi-square test and one way ANOVA. RESULTS: Among the 90 participants, 43.3% belonged to upper lower class and 38.3% to lower class. Buccal mucosa (58.9%) was found to be the most frequent site. Among the clinical staging, Stage II (33.33%) oral cancer was more prevalent. No statistically significant differences in the OHIP mean score for Groups, I, II, III. Among the domains functional limitation was significantly different in the three groups. CONCLUSION: Patients with oral malignancies who had been treated surgically alone had better Quality of life when compared to the combined treatment modalities.
