Free-flap head and neck reconstruction and quality of life: a 2-year prospective study

Laryngoscope. 2008 May;118(5):874-80. doi: 10.1097/MLG.0b013e3181644abd.

Abstract

Objectives: This prospective study was designed to evaluate quality of life (QOL) after free-flap head and neck reconstruction.

Study design: Prospective study.

Methods: : Between January 2004 and December 2005, a total of 95 patients underwent microvascular reconstruction of the head and neck at our Institution (Centre Antoine-Lacassagne, Nice, France) and were initially included in this study. The European Organization for Research and Treatment of Cancer (EORTC) Core Quality of Life Questionnaire and the EORTC Head and Neck Cancer Quality of Life Questionnaire were completed before surgery, and at 6 and 12 months thereafter. Sixty-five patients completed the questionnaires on at least two of the assessment dates. Predictive factors of Quality of Life (QOL) scores at 6 months were researched among the following: age, sex, comorbidity, radiotherapy, tumor recurrence, tumor stage, and type of surgery.

Results: Global QOL remained stable over time. Physical, social, and role functioning deteriorated significantly after treatment. Pain decreased markedly. Social eating, senses, and speech difficulties increased significantly at 6 months, but stabilized between 6 and 12 months. Problems concerning mouth opening and social contact augmented progressively until the 12th postoperative month. Sex, type of surgery, and radiotherapy were the main factors influencing QOL 6 months after treatment.

Conclusions: Despite some functional impairments, global QOL was preserved after major head and neck ablative surgery and microvascular free-flap reconstruction.

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Squamous Cell / psychology*
  • Carcinoma, Squamous Cell / radiotherapy
  • Carcinoma, Squamous Cell / surgery*
  • Combined Modality Therapy
  • Disease Progression
  • Female
  • Humans
  • Laryngeal Neoplasms / psychology*
  • Laryngeal Neoplasms / radiotherapy
  • Laryngeal Neoplasms / surgery*
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Neoplasm Staging
  • Oropharyngeal Neoplasms / psychology*
  • Oropharyngeal Neoplasms / radiotherapy
  • Oropharyngeal Neoplasms / surgery*
  • Paranasal Sinus Neoplasms / psychology*
  • Paranasal Sinus Neoplasms / radiotherapy
  • Paranasal Sinus Neoplasms / surgery*
  • Plastic Surgery Procedures / methods*
  • Prospective Studies
  • Quality of Life / psychology*
  • Speech Intelligibility
  • Surgical Flaps*
  • Surveys and Questionnaires
  • Time Factors