Maxillofac Plast Reconstr Surg.  2017 Sep;39(9):26. 10.1186/s40902-017-0125-1.

Determinants for further wishes for cosmetic and reconstructive interventions in 1652 patients with surgical treated carcinomas of the oral cavity

• Holtmann H
• Spalthoff
• Gellrich N
• Handschel
• Lommen J
• Kübler NR
• Krüskemper G
• Rana M
• Sander K

• KMID: 2395276
• DOI: http://doi.org/10.1186/s40902-017-0125-1

Abstract

BACKGROUND
The impairment of the appearance is a major problem for patients with carcinomas of the oral cavity. These patients want to recover their preoperative facial appearance. Some do not realize that this is not always possible and hence develop a desire for further cosmetic and reconstructive surgery (CRS) which often causes psychological problems. METHOD: The desire of patients for CRS (N = 410; 26%) has been acquired in this DÖSAK rehab study including multiple reasons such as medical, functional, aesthetic and psychosocial aspects. They relate to the parameters of diagnosis, treatment and postoperative rehabilitation. Patients without the wish for CRS (N = 1155; 74%) served as control group. For the surgeons, knowledge of the patient's views is relevant in the wish for CRS. Nevertheless, it has hardly been investigated for patients postoperatively to complete resection of oral cancer. In this retrospective cross-sectional study, questionnaires with 147 variables were completed during control appointments. Thirty-eight departments of Oral and Maxillofacial Surgery took part, and 1652 German patients at least 6 months after complete cancer resection answered the questions. Additionally, a physician's questionnaire (N = 1489) was available. Statistical analysis was performed with SPSS vers. 22.
RESULTS
The patient's assessment of their appearance and scarring are the most important criteria resulting in wishes for CRS. Furthermore, functional limitations such as eating/swallowing, pain of the facial muscles, numb regions in the operating field, dealing with the social environment, return to work, tumour size and location, removal and reconstruction are closely related.
CONCLUSION
The wish for CRS depends on diverse functional psychosocial and psychological parameters. Hence, it has to be issued during conversation to improve rehabilitation. A decision on the medical treatment can be of greater satisfaction if the surgeon knows the patients' needs and is able to compare them with the medical capabilities. The informed consent between doctor and patient in regard to these findings is necessary.

Keyword

Cosmetic surgery; Scarring; Quality of life; Depression; Coping; Oral cancer

MeSH Terms

Appointments and Schedules
Cicatrix
Cross-Sectional Studies
Depression
Diagnosis
Facial Muscles
Humans
Informed Consent
Methods
Mouth Neoplasms
Mouth*
Quality of Life
Rehabilitation
Retrospective Studies
Return to Work
Social Environment
Surgeons
Surgery, Oral
Surgery, Plastic