The Management of Patients after Surgical Treatment of Maxillofacial Tumors
Identifieur interne : 002923 ( Pmc/Curation ); précédent : 002922; suivant : 002924The Management of Patients after Surgical Treatment of Maxillofacial Tumors
Auteurs : D. Rolski [Pologne] ; J. Kostrzewa-Janicka [Pologne] ; P. Zawadzki [Pologne] ; K. Yci Ska [Pologne] ; E. Mierzwi Ska-Nastalska [Pologne]Source :
- BioMed Research International [ 2314-6133 ] ; 2016.
Abstract
Morphological and functional disturbances induced by postsurgical defects and loss of tissues in the stomatognathic system due to the treatment of tumors in the maxillofacial region determine the therapeutic needs of patients. The study aimed at clinical and epidemiological evaluation of patients under prosthetic treatment in order to establish the algorithm for rehabilitation. The study group was composed of the patients after midface surgery (45.74%); surgery in a lower part of the face (47.38%); mixed postoperative losses (3.44%); loss of face tissues and surgery in other locations in the head and neck region (3.44%). The supplementary treatment was applied in 69.63% of patients. Clinical and additional examinations were performed to obtain the picture of postoperative loss, its magnitude, and location to plan the strategy of prosthetic rehabilitation. The management algorithm for prosthetic rehabilitation in patients after surgical treatment of maxillofacial neoplasms was based on its division in stages. The location and magnitude of postoperative losses, as well as the implementation of supplementary treatment of the patients after treatment of maxillofacial tumors, influence the planning of prosthetic rehabilitation that plays a key role and facilitates the patients' return to their prior living situation, occupational and family lives.
Url:
DOI: 10.1155/2016/4045329
PubMed: 27747229
PubMed Central: 5056238
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<front><div type="abstract" xml:lang="en"><p>Morphological and functional disturbances induced by postsurgical defects and loss of tissues in the stomatognathic system due to the treatment of tumors in the maxillofacial region determine the therapeutic needs of patients. The study aimed at clinical and epidemiological evaluation of patients under prosthetic treatment in order to establish the algorithm for rehabilitation. The study group was composed of the patients after midface surgery (45.74%); surgery in a lower part of the face (47.38%); mixed postoperative losses (3.44%); loss of face tissues and surgery in other locations in the head and neck region (3.44%). The supplementary treatment was applied in 69.63% of patients. Clinical and additional examinations were performed to obtain the picture of postoperative loss, its magnitude, and location to plan the strategy of prosthetic rehabilitation. The management algorithm for prosthetic rehabilitation in patients after surgical treatment of maxillofacial neoplasms was based on its division in stages. The location and magnitude of postoperative losses, as well as the implementation of supplementary treatment of the patients after treatment of maxillofacial tumors, influence the planning of prosthetic rehabilitation that plays a key role and facilitates the patients' return to their prior living situation, occupational and family lives. </p>
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<title-group><article-title>The Management of Patients after Surgical Treatment of Maxillofacial Tumors</article-title>
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<contrib-group><contrib contrib-type="author"><name><surname>Rolski</surname>
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</name>
<xref ref-type="aff" rid="I2"><sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Życińska</surname>
<given-names>K.</given-names>
</name>
<xref ref-type="aff" rid="I3"><sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Mierzwińska-Nastalska</surname>
<given-names>E.</given-names>
</name>
<xref ref-type="aff" rid="I1"><sup>1</sup>
</xref>
</contrib>
</contrib-group>
<aff id="I1"><sup>1</sup>
Department of Prosthodontics, Medical University of Warsaw, Warsaw, Poland</aff>
<aff id="I2"><sup>2</sup>
Clinic of Cranio-Maxillo-Facial and Oral Surgery and Implantology, Medical University of Warsaw, Warsaw, Poland</aff>
<aff id="I3"><sup>3</sup>
Department of Family Medicine, Internal and Metabolic Diseases, Medical University of Warsaw and Systemic Vasculitis Outpatient Clinic, Czerniakowski Hospital, Warsaw, Poland</aff>
<author-notes><corresp id="cor1">*J. Kostrzewa-Janicka: <email>kostrzewa@stoma-med.net</email>
</corresp>
<fn fn-type="other"><p>Academic Editor: Moustafa N. Aboushelib</p>
</fn>
</author-notes>
<pub-date pub-type="ppub"><year>2016</year>
</pub-date>
<pub-date pub-type="epub"><day>26</day>
<month>9</month>
<year>2016</year>
</pub-date>
<volume>2016</volume>
<elocation-id>4045329</elocation-id>
<history><date date-type="received"><day>25</day>
<month>2</month>
<year>2016</year>
</date>
<date date-type="accepted"><day>10</day>
<month>8</month>
<year>2016</year>
</date>
</history>
<permissions><copyright-statement>Copyright © 2016 D. Rolski et al.</copyright-statement>
<copyright-year>2016</copyright-year>
<license xlink:href="https://creativecommons.org/licenses/by/4.0/"><license-p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>
<abstract><p>Morphological and functional disturbances induced by postsurgical defects and loss of tissues in the stomatognathic system due to the treatment of tumors in the maxillofacial region determine the therapeutic needs of patients. The study aimed at clinical and epidemiological evaluation of patients under prosthetic treatment in order to establish the algorithm for rehabilitation. The study group was composed of the patients after midface surgery (45.74%); surgery in a lower part of the face (47.38%); mixed postoperative losses (3.44%); loss of face tissues and surgery in other locations in the head and neck region (3.44%). The supplementary treatment was applied in 69.63% of patients. Clinical and additional examinations were performed to obtain the picture of postoperative loss, its magnitude, and location to plan the strategy of prosthetic rehabilitation. The management algorithm for prosthetic rehabilitation in patients after surgical treatment of maxillofacial neoplasms was based on its division in stages. The location and magnitude of postoperative losses, as well as the implementation of supplementary treatment of the patients after treatment of maxillofacial tumors, influence the planning of prosthetic rehabilitation that plays a key role and facilitates the patients' return to their prior living situation, occupational and family lives. </p>
</abstract>
<funding-group><award-group><funding-source xlink:href="http://dx.doi.org/10.13039/501100004281">Narodowe Centrum Nauki</funding-source>
<award-id>NN403 122740</award-id>
</award-group>
</funding-group>
</article-meta>
</front>
<floats-group><table-wrap id="tab1" orientation="portrait" position="float"><label>Table 1</label>
<caption><p>Baseline characteristics.</p>
</caption>
<table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1"> </th>
<th align="center" rowspan="1" colspan="1">% (<italic>n</italic>
)</th>
<th align="center" rowspan="1" colspan="1"><italic>X</italic>
± SD</th>
</tr>
</thead>
<tbody><tr><td align="left" rowspan="1" colspan="1"><italic>Age</italic>
</td>
<td align="center" rowspan="1" colspan="1">12–93 years</td>
<td align="center" rowspan="1" colspan="1">58.36 ± 7.56</td>
</tr>
<tr><td align="center" colspan="3" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"><italic>Gender</italic>
</td>
<td align="center" rowspan="1" colspan="1"> </td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Female</td>
<td align="center" rowspan="1" colspan="1">44.33 (219/494)</td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Male</td>
<td align="center" rowspan="1" colspan="1">55.67 (275/494)</td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="center" colspan="3" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"><italic>Postoperative loss</italic>
</td>
<td align="center" rowspan="1" colspan="1"> </td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Group I</td>
<td align="center" rowspan="1" colspan="1">44.75 (226/495)</td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> Bone loss<sup>1</sup>
</td>
<td align="center" rowspan="1" colspan="1">92.03 (208/226)</td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> Class I</td>
<td align="center" rowspan="1" colspan="1">41.83 (87/208)</td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> Class II</td>
<td align="center" rowspan="1" colspan="1">27.41 (57/208)</td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> Class III</td>
<td align="center" rowspan="1" colspan="1">6.73 (14/208)</td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> Class IV</td>
<td align="center" rowspan="1" colspan="1">8.17 (17/208)</td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> Class V</td>
<td align="center" rowspan="1" colspan="1">2.88 (6/208)</td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> Class VI</td>
<td align="center" rowspan="1" colspan="1">12.98 (27/208)</td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Group II</td>
<td align="center" rowspan="1" colspan="1">47.37 (234/494)</td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> Bone loss<sup>2</sup>
</td>
<td align="center" rowspan="1" colspan="1">69.23 (162/234)</td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> Class A</td>
<td align="center" rowspan="1" colspan="1">40.12 (65/162)</td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> A1</td>
<td align="center" rowspan="1" colspan="1">40.00 (26/65)</td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> A2</td>
<td align="center" rowspan="1" colspan="1">46.15 (30/65)</td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> A3</td>
<td align="center" rowspan="1" colspan="1">13.85 (9/65)</td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> Class B</td>
<td align="center" rowspan="1" colspan="1">27.16 (44/162)</td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> B1</td>
<td align="center" rowspan="1" colspan="1">9.09 (4/44)</td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> B2</td>
<td align="center" rowspan="1" colspan="1">75.00 (33/44)</td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> B3</td>
<td align="center" rowspan="1" colspan="1">15.91 (7/44)</td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> Class C</td>
<td align="center" rowspan="1" colspan="1">32.72 (53/162)</td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> C1</td>
<td align="center" rowspan="1" colspan="1">94.34 (50/53)</td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> C2</td>
<td align="center" rowspan="1" colspan="1">5.66 (3/53)</td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> C3</td>
<td align="center" rowspan="1" colspan="1">0.00 (0/53)</td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Group III</td>
<td align="center" rowspan="1" colspan="1">3.44 (17/494)</td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Group IV</td>
<td align="center" rowspan="1" colspan="1">3.44 (17/494)</td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="center" colspan="3" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"><italic>Supplementary treatment</italic>
</td>
<td align="center" rowspan="1" colspan="1">69.63 (344/494)</td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Radiotherapy</td>
<td align="center" rowspan="1" colspan="1">85.47 (294/344)</td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Chemotherapy</td>
<td align="center" rowspan="1" colspan="1">4.65 (16/344)</td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Radio- and chemotherapy</td>
<td align="center" rowspan="1" colspan="1">9.88 (34/344)</td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="center" colspan="3" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"><italic>Cause of surgical treatment</italic>
</td>
<td align="center" rowspan="1" colspan="1"> </td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Squamous carcinoma</td>
<td align="center" rowspan="1" colspan="1">66.40 (328/494)</td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Ameloblastoma</td>
<td align="center" rowspan="1" colspan="1">3.24 (16/494)</td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Tumor mixtus</td>
<td align="center" rowspan="1" colspan="1">2.43 (12/494)</td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Adenocarcinoma</td>
<td align="center" rowspan="1" colspan="1">2.02 (10/494)</td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Other</td>
<td align="center" rowspan="1" colspan="1">25.91 (128/494)</td>
<td align="center" rowspan="1" colspan="1"> </td>
</tr>
</tbody>
</table>
<table-wrap-foot><fn><p><sup>1</sup>
Aramany's classification; <sup>2</sup>
Furuta classification.</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="tab2" orientation="portrait" position="float"><label>Table 2</label>
<caption><p>Number of patients subjected to prosthetic treatment after surgical removal of tumors in the head and neck region by the years of observation.</p>
</caption>
<table frame="hsides" rules="groups"><thead><tr><th rowspan="2" align="left" colspan="1">Years of observation</th>
<th rowspan="2" align="center" colspan="1">Patients (<italic>n</italic>
)</th>
<th colspan="4" align="center" rowspan="1">Location of tumors</th>
</tr>
<tr><th align="center" rowspan="1" colspan="1">Group I (<italic>n</italic>
)</th>
<th align="center" rowspan="1" colspan="1">Group II (<italic>n</italic>
)</th>
<th align="center" rowspan="1" colspan="1">Group III (<italic>n</italic>
)</th>
<th align="center" rowspan="1" colspan="1">Group IV (<italic>n</italic>
)</th>
</tr>
</thead>
<tbody><tr><td align="left" rowspan="1" colspan="1">1999–2002</td>
<td align="center" rowspan="1" colspan="1">36</td>
<td align="center" rowspan="1" colspan="1">19</td>
<td align="center" rowspan="1" colspan="1">13</td>
<td align="center" rowspan="1" colspan="1">2</td>
<td align="center" rowspan="1" colspan="1">2</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">2003–2006</td>
<td align="center" rowspan="1" colspan="1">137</td>
<td align="center" rowspan="1" colspan="1">64</td>
<td align="center" rowspan="1" colspan="1">59</td>
<td align="center" rowspan="1" colspan="1">8</td>
<td align="center" rowspan="1" colspan="1">6</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">2007–2010</td>
<td align="center" rowspan="1" colspan="1">191</td>
<td align="center" rowspan="1" colspan="1">93</td>
<td align="center" rowspan="1" colspan="1">87</td>
<td align="center" rowspan="1" colspan="1">4</td>
<td align="center" rowspan="1" colspan="1">7</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">2011–2013</td>
<td align="center" rowspan="1" colspan="1">130</td>
<td align="center" rowspan="1" colspan="1">50</td>
<td align="center" rowspan="1" colspan="1">75</td>
<td align="center" rowspan="1" colspan="1">3</td>
<td align="center" rowspan="1" colspan="1">2</td>
</tr>
<tr><td align="center" colspan="6" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Total</td>
<td align="center" rowspan="1" colspan="1">494</td>
<td align="center" rowspan="1" colspan="1">226</td>
<td align="center" rowspan="1" colspan="1">234</td>
<td align="center" rowspan="1" colspan="1">17</td>
<td align="center" rowspan="1" colspan="1">17</td>
</tr>
</tbody>
</table>
</table-wrap>
<table-wrap id="tab3" orientation="portrait" position="float"><label>Table 3</label>
<caption><p>Characteristics of postoperative patients classified for prosthetic rehabilitation. </p>
</caption>
<table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">Postoperative bone loss</th>
<th align="center" rowspan="1" colspan="1">Prosthetic characteristics</th>
<th align="center" rowspan="1" colspan="1">% (<italic>n</italic>
)</th>
</tr>
</thead>
<tbody><tr><td align="left" rowspan="1" colspan="1">Group I</td>
<td align="center" rowspan="1" colspan="1"> </td>
<td align="center" rowspan="1" colspan="1">93.03 (208/226)</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> </td>
<td align="center" rowspan="1" colspan="1">Reconstruction of bone loss in maxilla</td>
<td align="center" rowspan="1" colspan="1">6.73 (14/208)</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> </td>
<td align="center" rowspan="1" colspan="1">Postoperative bone loss in maxilla</td>
<td align="center" rowspan="1" colspan="1">93.27 (194/208)</td>
</tr>
<tr><td align="center" colspan="3" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Group II</td>
<td align="center" rowspan="1" colspan="1"> </td>
<td align="center" rowspan="1" colspan="1">69.23 (162/234)</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> </td>
<td align="center" rowspan="1" colspan="1">Reconstruction of bone loss in mandible</td>
<td align="center" rowspan="1" colspan="1">21.61 (35/162)</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> </td>
<td align="center" rowspan="1" colspan="1">Postoperative bone loss in mandible</td>
<td align="center" rowspan="1" colspan="1">78.39 (127/162)</td>
</tr>
<tr><td align="center" colspan="3" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Group III</td>
<td align="center" rowspan="1" colspan="1"> </td>
<td align="center" rowspan="1" colspan="1">3.44 (17/494)</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> </td>
<td align="center" rowspan="1" colspan="1">Reconstruction of bone loss in maxilla & mandible</td>
<td align="center" rowspan="1" colspan="1">5.88 (1/17)</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"> </td>
<td align="center" rowspan="1" colspan="1">Postoperative bone loss</td>
<td align="center" rowspan="1" colspan="1"> 94.12 (16/17)</td>
</tr>
</tbody>
</table>
</table-wrap>
</floats-group>
</pmc>
</record>
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