Can we assess quality of life in patients with head and neck cancer? A preliminary report from the American Academy of Maxillofacial Prosthetics.

Survival statistics alone may no longer be valid when used as evidence of effective outcomes. Patient satisfaction is an end point that needs further evaluation and should be included in the outcomes assessment. A 133-item questionnaire has been designed by a special committee of the American Academy of Maxillofacial Prosthetics (AAMP) to assess the quality of life of patients with head and neck cancer impacting the orofacial region. This survey will be distributed to the entire population of 7 geographically dispersed treatment centers in the United States for a 2-year period. Patients will be stratified into several subgroups, including radiation/nonradiation, maxillary/mandibular, and surgical reconstruction/prostheses. Separate analyses will be conducted for each subgroup, and comparisons will be made within subgroups to test the sensitivity of the questionnaire to a known difference. A revised version of the AAMP questionnaire, limited to 50 items of interest to patients, will be validated against 2 established head and neck cancer questionnaires. This article provides background on previous quality-of-life studies and reviews the need for and aims of the AAMP assessment instrument.

Small intestinal submucosa versus salt-extracted polyglycolic acid-poly-L-lactic acid: a comparison of neocartilage formed in two scaffold materials.

This study sought to compare differences in neocartilage produced over time from two types of resorbable scaffold materials. One material was entirely synthetic and contained a polyglycolic acid-poly-L-lactic acid matrix (PGA-PLLA). The second scaffold material was bioactive and consisted of a four-layered construct of porcine small intestinal submucosa (SIS). Disk-shaped scaffolds were seeded with canine chondrocytes and implanted into athymic mice for periods of 5, 8, 12, and 24 weeks. Constructs were examined microscopically, assayed for hydroxyproline (HP) and glycosaminoglycan (GAG) content, and collagen typed (I or II) at each time period. Creep indentation tests determined aggregate and shear modulus, permeability, and thickness. Results indicated that SIS maintained its thickness through the first 12 weeks, and then doubled by week 24. The 24-week tissue appeared chondroid-like and possessed high GAG content. Tissues derived from PGA-PLLA scaffolds were lower in HP content than SIS-derived tissues, but type II collagen was demonstrated only in PGA-PLLA-derived tissues at 24 weeks. Mechanical properties were not significantly different for any tissue over time (p > 0.05), but aggregate and shear modulus mean values were consistently higher for PGA-PLLA-derived tissues at nearly every time interval. This, coupled with the presence of collagen types I and II, suggested a more congruent solid phase may be forming within the extracellular matrix of tissues derived from PGA-PLLA scaffolds. Future study is necessary to compare these materials under simulated loading conditions.