Assessment of Quality of Life in Head-and-Neck Oncologic Patients with Intraoral Soft-Tissue Defects Reconstructed with Buccinator Myomucosal Flap
Abstract
:1. Introduction
2. Materials and Methods
2.1. Questionnaires
2.2. Reliability
2.3. Data Recording
2.4. Statistical Analysis
3. Results
4. Discussion
- (a)
- Posterior buccinator myomucosal flap: based on the buccal artery (branch of the maxillary artery) and the posterior buccal artery (branch of the facial artery), which can be a pedicled flap or an island flap.
- (b)
- Superior buccinator myomucosal flap: based on the angular artery (branch of the facial artery) with retrograde flow, which can be harvested as a pedicle flap or island flap.
- (c)
- Inferior buccinator myomucosal flap: based on the facial artery with anterograde flow, which can be pedicled (facial artery myomucosal flap or FAMM flap) or dissected as an island flap (Zhao flap) [12].
- (d)
- Anterior buccinator myomucosal flap: pedicled over the anterior buccal artery (branch of the facial artery).
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variable | Category | Frequency | |
---|---|---|---|
n | % | ||
Age | ≤60 | 20 | 51.3 |
>60 | 19 | 48.7 | |
Gender | Male | 19 | 48.7 |
Female | 20 | 51.3 | |
Smoking | No | 20 | 51.3 |
Yes | 19 | 48.7 | |
Alcohol consumption | No | 30 | 76.9 |
Yes | 9 | 23 | |
Diagnosis | Oncologic (Primary tumor) | 31 | 79,5 |
Oncologic (Recurrence) | 2 | 5,1 | |
Iatrogenic sequelae | 5 | 12.8 | |
Congenital sequelae | 1 | 2.6 | |
Tumor site | Tongue | 13 | 33.3 |
Mouth floor | 9 | 23 | |
Lower jaw gingiva | 3 | 7.7 | |
Upper jaw gingiva | 6 | 15.4 | |
Palate | 8 | 20.5 | |
Resection | Soft tissue | 25 | 64.1 |
Combined tissue | 14 | 35.9 | |
Need for another flap | No | 26 | 66.7 |
Yes | 13 | 33.3 | |
Bichat’s flaps | 12 | 92.3 | |
Other | 1 | 7.7 | |
Stage (AJCC) | None | 10 | 25.6 |
I | 9 | 23 | |
II | 12 | 30.8 | |
III | 6 | 15.4 | |
IVa | 1 | 2.6 | |
IVb | 1 | 2.6 | |
Radiotherapy | No | 24 | 61.5 |
Yes | 15 | 38.5 | |
Complications | None | 24 | 61.5 |
Partial necrosis | 6 | 15.4 | |
Complete necrosis | 1 | 2.6 | |
Trismus | 5 | 12.8 | |
Infection/dehiscence | 2 | 5.1 | |
Neuropatic pain | 1 | 2.6 | |
Edentulism | Partial | 21 | 53.9 |
Complete | 16 | 41 | |
No | 2 | 5.1 | |
Dental rehabilitation | No | 12 | 30.8 |
Yes * | 16 | 41 | |
In process | 11 | 28.2 | |
Follow-up | ≤3 | 23 | 59 |
>3 | 16 | 41 |
QLQ-C30 Scale Name | Mean Score | SD | Median Score | IQR | Range |
---|---|---|---|---|---|
Functional scales | |||||
Physical function | 78.6 | 21 | 83.3 | (66.7–100) | (33.3–100.00) |
Role function | 85 | 23.5 | 100. | (83.3–100) | (0–100) |
Emotional function | 76.9 | 23 | 83.3 | (66.7–91.7) | (0–100) |
Cognitive function | 90.2 | 21.9 | 100 | (83.3–100) | (0–100) |
Social function | 85.5 | 27.4 | 100 | (83.3–100) | (0–100) |
Symptom scales/items | |||||
Fatigue | 17.7 | 16.7 | 11.1 | (0–22) | (0–55.6) |
Nausea and vomiting | 2.1 | 7.8 | 0 | (0–0) | (0–33.3) |
Pain | 20.1 | 19.6 | 16.7 | (0–33.3) | (0–66.7) |
Dyspnea | 11.1 | 20.7 | 0 | (0–33.3) | (0–66.7) |
Insomnia | 13.7 | 21.2 | 0 | (0–33.3) | (0–66.7) |
Appetite loss | 8.6 | 18.3 | 0 | (0–0) | (0–66.7) |
Constipation | 12 | 24.8 | 0 | (0–33.3) | (0–100) |
Diarrhea | 3.4 | 10.3 | 0 | (0–0) | (0–33.3) |
Financial difficulties | 9.4 | 22.9 | 0 | (0–0) | (0–100) |
Global health status/qol | |||||
Global health status | 79.3 | 19.8 | 83.3 | (75–91.7) | (16.7–100) |
Scale Name | Mean Score | SD | Median Score | IQR | Range |
---|---|---|---|---|---|
Symptom scales/items | |||||
Pain | 19.9 | 18.8 | 16.7 | (8.3–25) | (0–75) |
Swallowing | 12.8 | 18.3 | 8.3 | (0–25) | (0–75) |
Teeth | 33.3 | 34.2 | 33.3 | (0–66.7) | (0–100) |
Opening mouth | 31.6 | 31.5 | 33.3 | (0–66.7) | (0–100) |
Dry mouth | 376 | 38.4 | 33.3 | (0–66.7) | (0–100) |
Sticky saliva | 24.8 | 29.3 | 0 | (0–33.3) | (0–100) |
Sense problems | 9.8 | 23.5 | 0 | (0–0) | (0–100) |
Coughing | 14.5 | 22.7 | 0 | (0–33.3) | (0–100) |
Feeling ill | 8.6 | 19.8 | 0 | (0–0) | (0–100) |
Speech problems | 14.5 | 19.1 | 11.1 | (0–22.2) | (0–100) |
Troubles with social eating | 21.2 | 22.2 | 16.7 | (0–33.3) | (0–100) |
Troubles with social contact | 10.6 | 19.2 | 0 | (0–13.3) | (0–73.3) |
Less sexuality | 16.2 | 26.4 | 0 | (0–33.3) | (0–100) |
Pain killers | 46.2 | 50.5 | 0 | (0–100) | (0–100) |
Nutritional supplements | 5.1 | 22.4 | 0 | (0–0) | (0–100) |
Feeding tube | 89.7 | 30.7 | 100 | (100–100) | (0–100) |
Weight loss | 30.8 | 46.8 | 0 | (0–100) | (0–100) |
Weight gain | 43.6 | 50.2 | 0 | (0–100) | (0–100) |
Variable | Categories | QLQ-C30 Questionnaire | |||||
---|---|---|---|---|---|---|---|
Functional Scale | Symptom Scale | Global Health Status | |||||
Score (Mean ± SD) | p Value | Score (Mean ± SD) | p Value | Score (Mean ± SD) | p Value | ||
Gender | Male | 80.6 ± 18.8 | 0.139 | 11.8 ± 11.1 | 0.513 | 77.6 ± 21.4 | 0.629 |
Female | 85.7 ± 19.1 | 10.2 ± 10.9 | 80.8 ± 18.6 | ||||
Age | ≤60 | 82.1 ± 21.2 | 0.933 | 11.9 ± 11.5 | 0.855 | 77.5 ± 21.1 | 0.528 |
>60 | 84.4 ± 16.6 | 10 ± 10.4 | 81.1 ± 18.6 | ||||
Smoker | Yes | 80.6 ± 26.2 | 0.373 | 12.2 ± 19.7 | 0.537 | 82.1 ± 15.6 | 0.403 |
No | 85.8 ± 20.5 | 9.6 ± 15.7 | 76.3 ± 23.5 | ||||
Alcohol consumption | Yes | 80.4 ± 26.5 | 0.557 | 12.8 ± 19.3 | 0.34 | 79.4 ± 18 | 0.741 |
No | 84.1 ± 22.4 | 10.3 ± 16.8 | 78.7 ± 26.1 | ||||
Diagnosis | Primary tumour | 80.3 ± 20 | 0.030 | 12.6 ± 11.7 | 0.218 | 76.9 ± 20.9 | 0.250 |
Recurrence | 92.5 ± 0.7 | 5 ± 1.4 | 83.3 ± 11.8 | ||||
Sequelae | 95.3 ± 7.6 | 4.7 ± 3.3 | 90.3 ± 11.1 | ||||
Tumour site | Tongue | 80.2 ± 21.9 | 0.077 | 10.4 ± 11 | 0.302 | 74.4 ± 14.6 | 0.081 |
Floor of the mouth | 75.1 ± 24.2 | 15.2 ± 11.2 | 71.3 ± 33.1 | ||||
Lower jaw gingiva | 78.3 ± 11.6 | 18.3 ± 21.4 | 77.8 ± 9.6 | ||||
Upper jaw gingiva | 91.5 ± 4.6 | 6.5 ± 5.4 | 87.5 ± 7 | ||||
Palate | 93 ± 10.3 | 7.5 ± 8.1 | 90.6 ± 10.4 | ||||
Defect Size | <5 cm | 84.2 ± 19 | 0.713 | 13 ± 21.1 | 0.585 | 88.5 ± 13.3 | 0.426 |
5–10 cm | 78.8 ± 30.1 | 11.2 ± 16.5 | 72.8 ± 27.7 | ||||
10–15 cm | 84.9 ± 20.3 | 11.7 ± 20.1 | 81.82 ± 11.1 | ||||
>15 cm | 91.7 ± 10.9 | 5.1 ± 5.7 | 78.3 ± 7.5 | ||||
Stage (AJCC) | No malignant | 93.2 ± 9.5 | 0.144 | 5.7 ± 7.4 | 0.260 | 89.2 ± 9.7 | 0.217 |
I | 76.8 ± 2.4 | 11.6 ± 8.8 | 72.2 ± 28 | ||||
II | 78.3 ± 22.1 | 14.3 ± 12.4 | 79.2 ± 22.9 | ||||
III | 82.8 ± 12.1 | 12.2 ± 15.2 | 76.4 ± 8.2 | ||||
IVA | 93 | 4 | 66.7 | ||||
IVB | 93 | 4 | 75 | ||||
RT | Yes | 81.1 ± 17.7 | 0.139 | 11.3 ± 10.6 | 0.409 | 75.6 ± 14.6 | 0.034 |
No | 84.6 ± 19.8 | 10.8 ± 11.3 | 81.6 ± 22.4 | ||||
Dental rehabilitation | Yes | 85.5 ± 19.3 | 0.650 | 10.2 ± 17.7 | 0.420 | 85.4 ± 12 | 0.256 |
No | 81.6 ± 26.9 | 11 ± 16.9 | 74.6 ± 24.1 | ||||
Follow-up | </=3 years | 81.1 ± 26.5 | 0.629 | 10.7 ± 17 | 0.690 | 75.4 ± 23.5 | 0.270 |
>3 years | 86.4 ± 18.6 | 11.2 ± 18.9 | 84.9 ± 11.1 |
Variable | Categories | QLQ-H&N35 QUESTIONNAIRE | |||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Pain | Swallowing | Teeth | Opening Mouth | Dry Mouth | Sticky Saliva | Pain Killers | |||||||||
Score (M ± SD) | p Value | Score (M ± SD) | p Value | Score (M ± SD) | p Value | Score M ± SD) | p value | Score (M ± SD) | p Value | Score (M ± SD) | p Value | Score (M ± SD) | p Value | ||
Gender | Male | 26.3 ± 18.9 | 0.009 | 12.7 ± 19.1 | 0.722 | 33.3 ± 33.3 | 0.917 | 35.1 ± 34.2 | 0.572 | 36.8 ± 39.9 | 0.858 | 28.1 ± 31.9 | 0.560 | 73.7 ± 45.2 | 0.001 |
Female | 13.8 ± 16.9 | 12.9 ± 18 | 33.3 ± 35.9 | 28.3 ± 29.2 | 38.3 ± 37.9 | 21.7 ± 27.1 | 20 ± 41 | ||||||||
Age | ≤60 | 19.2 ± 18 | 0.558 | 10.4 ± 18.3 | 0.219 | 28.3 ± 31.1 | 0.405 | 33.3 ± 30.6 | 0.647 | 46.7 ± 28.1 | 0.141 | 28.3 ± 24.8 | 0.209 | 5 ± 22.4 | 0.435 |
>60 | 20.6 ± 20.1 | 15.4 ± 19.5 | 38.6 ± 37.3 | 29.8 ± 33.1 | 28.1 ± 37.3 | 21.1 ± 33.7 | 52.6 ± 51.3 | ||||||||
Smoker | Yes | 20.4 ± 17.6 | 0.585 | 12.9 ± 18 | 0.847 | 35 ± 33.3 | 0.645 | 28.3 ± 32.9 | 0.396 | 38.3 ± 43.6 | 0.976 | 25 ± 30.4 | 0.988 | 55 ± 51 | 0.262 |
No | 19.3 ± 20.4 | 12.7 ± 19.1 | 31.6 ± 36 | 35.1 ± 30.4 | 36.9 ± 33.1 | 24.6 ± 29.1 | 36.8 ± 49.6 | ||||||||
Alcohol consumption | Yes | 20 ± 17.7 | 0.670 | 14.4 ± 20.2 | 0.574 | 33.3 ± 35 | 0.916 | 32.2 ± 30.9 | 0.737 | 38.9 ± 39.2 | 0.738 | 27.8 ± 29.1 | 0.173 | 50 ± 50.9 | 0.385 |
No | 19.4 ± 23.2 | 7.4 ± 8.8 | 33.3 ± 33.3 | 29.6 ± 35.1 | 33.3 ± 37.3 | 14.8 ± 29.4 | 33.3 ± 50 | ||||||||
Diagnosis | Primary tumour | 21.8 ± 20.3 | 0.45 | 13.2 ± 16.4 | 0.523 | 33.3 ± 33.3 | 0.983 | 34.4 ± 32.8 | 0.587 | 40.9 ± 30.2 | 0.518 | 25.8 ± 29.5 | 0.719 | 51.6 ± 50.8 | 0.298 |
Recurrence | 8.3 | 4.2 ± 5.9 | 33.3 ± 47.1 | 16.7 ± 23.8 | 33.3 ± 47.1 | 33.3 ± 47.1 | 0 | ||||||||
Sequelae | 13.9 ± 10.1 | 13.9 ± 30.1 | 33.3 ± 42.2 | 22.2 ± 27.2 | 22.2 ± 34.4 | 16.7 ± 27.9 | 33.3 ± 51.6 | ||||||||
Tumour site | Tongue | 18.6 ± 21 | 0.390 | 19.9 ± 18.2 | 0.089 | 35.9 ± 34.6 | 0.879 | 38.5 ± 32.9 | 0.664 | 61.5 ± 35.6 | 0.071 | 30.8 ± 28.7 | 0.546 | 30.8 ± 48 | 0.252 |
Floor of the mouth | 24.1 ± 23.7 | 6.5 ± 9.1 | 33.3 ± 33.3 | 33.3 ± 33.3 | 3.3 ± 37.3 | 22.2 ± 28.7 | 55.6 ± 52.7 | ||||||||
Lower jaw gingiva | 38.9 ± 21 | 19.4 ± 26.8 | 44.4 ± 50.9 | 44.4 ± 50.9 | 33.3 ± 57.7 | 44.4 ± 50.9 | 100 | ||||||||
Upper jaw gingiva | 12.5 ± 4.6 | 2.8 ± 4.3 | 33.3 ± 29.8 | 16.7 ± 18.3 | 22.2 ± 27.2 | 22.2 ± 27.2 | 33.3 ± 51.6 | ||||||||
Palate | 15.6 ± 11.3 | 13.5 ± 26.3 | 25 ± 38.8 | 25 ± 29.6 | 16.7 ± 30.9 | 12.5 ± 24.8 | 50 ± 53.5 | ||||||||
Defect Size | <5 cm | 20.8 ± 13.4 | 0.143 | 14.6 ± 17.7 | 0.565 | 29.2 ± 37.5 | 0.836 | 33.3 ± 35.6 | 0.693 | 25 ± 38.8 | 0.651 | 16.7 ± 35.6 | 0.586 | 75 ± 46.3 | 0.243 |
5–10 cm | 28.3 ± 24.8 | 14.4 ± 24.7 | 33.3 ± 39.8 | 40 ± 38.2 | 37.8 ± 35.3 | 28.9 ± 30.5 | 40 ± 50.7 | ||||||||
10–15 cm | 12.9 ± 10.1 | 7.6 ± 10.2 | 36.4 ± 23.4 | 24.2 ± 21.6 | 39.4 ± 38.9 | 27.3 ± 25 | 45.5 ± 52.2 | ||||||||
>15 cm | 8.3 ± 8.3 | 16.7 ± 11.8 | 33.3 ± 40.8 | 20 ± 18.3 | 53.6 ± 50.6 | 20 ± 29.8 | 20 ± 44.7 | ||||||||
Stage (AJCC) | No malignant | 15 ± 8.6 | 0.613 | 8.3 ± 23.6 | 0.040 | 30 ± 36.7 | 0.581 | 30 ± 29.2 | 0.552 | 20 ± 28.1 | 0.079 | 20 ± 23.3 | 0.395 | 40 ± 51.6 | 0.816 |
I | 29.6 ± 21.7 | 13 ± 21.7 | 33.3 ± 37.3 | 33.3 ± 33.3 | 29.6 ± 38.9 | 22.2 ± 28.9 | 55.6 ± 52.7 | ||||||||
II | 18.1 ± 20.4 | 9 ± 10.9 | 22.8 ± 27.8 | 25 ± 32.2 | 33.3 ± 34.8 | 16.7 ± 26.6 | 50 ± 52.2 | ||||||||
III | 19.4 ± 25.1 | 26.4 ± 14.4 | 55.6 ± 40.4 | 50 ± 35 | 72.2 ± 39 | 44.4 ± 40.4 | 50 ± 54.8 | ||||||||
IVA | 16.7 | 25 | 33.3 | 33.3 | 100 | 33.3 | 0 | ||||||||
IVB | 8.3 | 8.3 | 0 | 0 | 66.7 | 66.7 | 0 | ||||||||
RT | Yes | 26.7 ± 16.4 | 0.046 | 26.1 ± 22.5 | 0.000 | 46.7 ± 37.4 | 0.043 | 42.2 ± 32 | 0.103 | 53.3 ± 43.3 | 0.039 | 33.3 ± 35.6 | 0.052 | 60 ± 50.7 | 0.176 |
No | 16 ± 20.6 | 4.5 ± 7.8 | 25 ± 29.9 | 25 ± 29.9 | 27.8 ± 32.1 | 19.4 ± 23.9 | 37.5 ± 49.5 | ||||||||
Dental rehabilitation | Yes | 15.1 ± 14.3 | 0.259 | 14.6 ± 20.1 | 0.606 | 33.3 ± 32.3 | 0.872 | 25 ± 25.8 | 0.362 | 33.3 ± 34.4 | 0.593 | 18.8 ± 27.1 | 0.292 | 43.8 ± 51.2 | 0.817 |
No | 23.8 ± 21.8 | 12.3 ± 18 | 36.5 ± 36.4 | 35.5 ± 34.8 | 41.3 ± 42 | 28.6 ± 30.3 | 47.6 ± 51.2 | ||||||||
Follow-up | </=3 years | 20.7 ± 19.8 | 0.849 | 16.3 ± 21.5 | 0.278 | 37.7 ± 39.3 | 0.576 | 37.7 ± 35.3 | 0.221 | 44.9 ± 37.1 | 0.123 | 27.5 ± 32.8 | 0.663 | 39.1 ± 60 | 0.298 |
>3 years | 18.8 ± 17.9 | 7.8 ± 11.2 | 27.1 ± 25 | 22.9 ± 23.5 | 27.1 ± 38.9 | 20.8 ± 24 | 56.3 ± 51.2 |
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Agea Martínez, M.; Antúnez-Conde, R.; Navarro Cuéllar, C.; Tousidonis Rial, M.; Navarro Cuéllar, I.; López López, A.M.; Gascón Alonso, D.; Sada Urmeneta, Á.; Zamorano-León, J.J. Assessment of Quality of Life in Head-and-Neck Oncologic Patients with Intraoral Soft-Tissue Defects Reconstructed with Buccinator Myomucosal Flap. J. Clin. Med. 2022, 11, 7458. https://doi.org/10.3390/jcm11247458
Agea Martínez M, Antúnez-Conde R, Navarro Cuéllar C, Tousidonis Rial M, Navarro Cuéllar I, López López AM, Gascón Alonso D, Sada Urmeneta Á, Zamorano-León JJ. Assessment of Quality of Life in Head-and-Neck Oncologic Patients with Intraoral Soft-Tissue Defects Reconstructed with Buccinator Myomucosal Flap. Journal of Clinical Medicine. 2022; 11(24):7458. https://doi.org/10.3390/jcm11247458
Chicago/Turabian StyleAgea Martínez, Marc, Raúl Antúnez-Conde, Carlos Navarro Cuéllar, Manuel Tousidonis Rial, Ignacio Navarro Cuéllar, Ana María López López, Dafne Gascón Alonso, Ángela Sada Urmeneta, and José J. Zamorano-León. 2022. "Assessment of Quality of Life in Head-and-Neck Oncologic Patients with Intraoral Soft-Tissue Defects Reconstructed with Buccinator Myomucosal Flap" Journal of Clinical Medicine 11, no. 24: 7458. https://doi.org/10.3390/jcm11247458