Long-term health-related quality of life (HRQOL) and functional outcomes following mandibular and maxillary reconstruction are lacking. To determine these outcomes, a cross-sectional study of patients with a history of cancer who underwent jaw reconstruction was undertaken. Participants were identified from a database of jaw reconstruction procedures at the Chris O’Brien Lifehouse (Sydney, Australia). Eligible patients had at least one month follow-up, were aged ≥18 years at surgery, and had history of malignancy. HRQOL was measured using the FACE-Q Head and Neck Cancer Module (FACE-Q H&N). Functional outcomes were measured using the FACE-Q H&N, MD Anderson Dysphagia Inventory (MDADI) and Speech Handicap Index (SHI). Ninety-seven questionnaires were completed (62% response rate). Mean age of respondents was 63.7 years, 61% were male, and 64% underwent radiotherapy. Treatment with radiotherapy was associated with worse outcomes across 10/14 FACE-Q H&N scales, three MDADI subscales and one composite score, and the SHI. Mean differences in scores between irradiated and non-irradiated patients exceeded clinically meaningful differences for the MDADI and SHI. Issues with oral competence, saliva, speaking, and swallowing worsened with increasing time since surgery. Younger patients reported greater concerns with appearance, smiling, speaking, and cancer worry. Women reported greater concerns regarding appearance and associated distress. History of radiotherapy substantially impacts HRQOL and function after jaw reconstruction. Age at surgery and gender were also predictors of outcomes and associated distress. Pre-treatment counselling of patients requiring jaw reconstruction may lead to improved survivorship for patients with head and neck cancer.

Trismus secondary to head and neck neoplasm treatment impacts upon quality of life, nutrition, oral hygiene, and dentition. Current treatment options for trismus apply unquantified force to the jaw...

Resection, reconstruction, and rehabilitation of the mandible impact function and health related quality of life (HRQOL). In this study, we aimed to understand the impact of delayed versus immediate dental implant placement. A cross-sectional and prospective study was conducted including patients who underwent reconstruction of the mandible via osseous vascularised bone flaps and dental implants. The FACE-Q Head and Neck Cancer module and the MD Anderson Dysphagia Inventory and Speech Handicap Index were used to evaluate HRQOL. A total of 187 implants were placed in 52 patients, of which 44 patients (85%) completed questionnaires. Immediate dental implant placement was associated with superior FACE-Q appearance (p = 0.02), oral competence (p = 0.004), smile distress (p = 0.03), and satisfaction with information (p = 0.004). Dentoalveolar rehabilitation through the placement of immediate dental implants at the time of surgery was found to be associated with higher HRQOL scores related to appearance, eating and drinking, oral competence, and smile.