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Li CQ, Xie S, LiuFu JF, Ding MK, Kang YF, Shan XF, Cai ZG. Retrospective study of the deep circumflex iliac artery flap and the vascularized fibula free flap for maxillary defect repair. Oral Oncol 2024; 154:106860. [PMID: 38801787 DOI: 10.1016/j.oraloncology.2024.106860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 05/09/2024] [Accepted: 05/18/2024] [Indexed: 05/29/2024]
Abstract
OBJECTIVES The deep circumflex iliac artery flap (DCIA) and vascularized fibular free flap (FFF) are mainstay flaps for maxillary defect reconstruction. This study compared the functional outcomes and success rates of these flaps to provide midface reconstruction strategies. MATERIALS AND METHODS Maxillary defects reconstructed with DCIA or FFF at the Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology between May 2016 and May 2023 were retrospectively analyzed. The length, width, and height of the grafted bone segments; intermaxillary distance; buttress reconstruction rate (BRR); dental arch reconstruction rate (DAR); success rate; and dental implantation rate were compared. RESULTS The DCIA and FFF groups had 33 and 27 patients, respectively. Success rate in the DCIA group was 93.94 % and 100 % in the FFF group. The DCIA length was less than that of FFF; however, the width and height were significantly larger. 87.10 % of cases in the DCIA group were classified as Brown class b and c, 51.85 % of cases in the FFF group were classified as Brown class d. The average BRR in the DCIA group was 69.89 % ± 16.05 %, which was significantly higher than that in the FFF group. A total of 38.7 % and 11.1 % patients in the DCIA and FFF groups, respectively, had completed implantation. CONCLUSION DCIA has a greater width and height, and is more suitable for repairing Brown class b and c defects, providing sufficient bone for implantation, while the FFF is longer and more suitable for Brown class d defect reconstruction.
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Affiliation(s)
- Cheng-Qian Li
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases &National Engineering Research Center of Oral Biomaterial and Digital Medical Devices, PR China
| | - Shang Xie
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases &National Engineering Research Center of Oral Biomaterial and Digital Medical Devices, PR China
| | - Jian-Feng LiuFu
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases &National Engineering Research Center of Oral Biomaterial and Digital Medical Devices, PR China
| | - Meng-Kun Ding
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases &National Engineering Research Center of Oral Biomaterial and Digital Medical Devices, PR China
| | - Yi-Fan Kang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases &National Engineering Research Center of Oral Biomaterial and Digital Medical Devices, PR China
| | - Xiao-Feng Shan
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases &National Engineering Research Center of Oral Biomaterial and Digital Medical Devices, PR China.
| | - Zhi-Gang Cai
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases &National Engineering Research Center of Oral Biomaterial and Digital Medical Devices, PR China
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Xin H, Ferguson BM, Wan B, Al Maruf DSA, Lewin WT, Cheng K, Kruse HV, Leinkram D, Parthasarathi K, Wise IK, Froggatt C, Crook JM, McKenzie DR, Li Q, Clark JR. A Preclinical Trial Protocol Using an Ovine Model to Assess Scaffold Implant Biomaterials for Repair of Critical-Sized Mandibular Defects. ACS Biomater Sci Eng 2024; 10:2863-2879. [PMID: 38696332 DOI: 10.1021/acsbiomaterials.4c00262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2024]
Abstract
The present work describes a preclinical trial (in silico, in vivo and in vitro) protocol to assess the biomechanical performance and osteogenic capability of 3D-printed polymeric scaffolds implants used to repair partial defects in a sheep mandible. The protocol spans multiple steps of the medical device development pipeline, including initial concept design of the scaffold implant, digital twin in silico finite element modeling, manufacturing of the device prototype, in vivo device implantation, and in vitro laboratory mechanical testing. First, a patient-specific one-body scaffold implant used for reconstructing a critical-sized defect along the lower border of the sheep mandible ramus was designed using on computed-tomographic (CT) imagery and computer-aided design software. Next, the biomechanical performance of the implant was predicted numerically by simulating physiological load conditions in a digital twin in silico finite element model of the sheep mandible. This allowed for possible redesigning of the implant prior to commencing in vivo experimentation. Then, two types of polymeric biomaterials were used to manufacture the mandibular scaffold implants: poly ether ether ketone (PEEK) and poly ether ketone (PEK) printed with fused deposition modeling (FDM) and selective laser sintering (SLS), respectively. Then, after being implanted for 13 weeks in vivo, the implant and surrounding bone tissue was harvested and microCT scanned to visualize and quantify neo-tissue formation in the porous space of the scaffold. Finally, the implant and local bone tissue was assessed by in vitro laboratory mechanical testing to quantify the osteointegration. The protocol consists of six component procedures: (i) scaffold design and finite element analysis to predict its biomechanical response, (ii) scaffold fabrication with FDM and SLS 3D printing, (iii) surface treatment of the scaffold with plasma immersion ion implantation (PIII) techniques, (iv) ovine mandibular implantation, (v) postoperative sheep recovery, euthanasia, and harvesting of the scaffold and surrounding host bone, microCT scanning, and (vi) in vitro laboratory mechanical tests of the harvested scaffolds. The results of microCT imagery and 3-point mechanical bend testing demonstrate that PIII-SLS-PEK is a promising biomaterial for the manufacturing of scaffold implants to enhance the bone-scaffold contact and bone ingrowth in porous scaffold implants. MicroCT images of the harvested implant and surrounding bone tissue showed encouraging new bone growth at the scaffold-bone interface and inside the porous network of the lattice structure of the SLS-PEK scaffolds.
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Affiliation(s)
- Hai Xin
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, NSW 2050, Australia
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2050, Australia
| | - Ben M Ferguson
- School of Aerospace, Mechanical and Mechatronic Engineering, The University of Sydney, Darlington, NSW 2006, Australia
| | - Boyang Wan
- School of Aerospace, Mechanical and Mechatronic Engineering, The University of Sydney, Darlington, NSW 2006, Australia
| | - D S Abdullah Al Maruf
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, NSW 2050, Australia
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2050, Australia
| | - William T Lewin
- Arto Hardy Biomedical Innovation Hub, Chris O'Brien Lifehouse, Camperdown, NSW 2050, Australia
- Sarcoma and Surgical Research Centre, Chris O'Brien Lifehouse, Camperdown, NSW 2050, Australia
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2006, Australia
| | - Kai Cheng
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, NSW 2050, Australia
- Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, Camperdown, NSW 2050, Australia
| | - Hedi V Kruse
- Arto Hardy Biomedical Innovation Hub, Chris O'Brien Lifehouse, Camperdown, NSW 2050, Australia
- Sarcoma and Surgical Research Centre, Chris O'Brien Lifehouse, Camperdown, NSW 2050, Australia
- School of Physics, Faculty of Science, The University of Sydney, Syndey, NSW 2006, Australia
| | - David Leinkram
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, NSW 2050, Australia
- Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, Camperdown, NSW 2050, Australia
| | - Krishnan Parthasarathi
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, NSW 2050, Australia
| | - Innes K Wise
- Laboratory Animal Services, The University of Sydney, Camperdown, NSW 2050, Australia
| | - Catriona Froggatt
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, NSW 2050, Australia
| | - Jeremy M Crook
- Arto Hardy Biomedical Innovation Hub, Chris O'Brien Lifehouse, Camperdown, NSW 2050, Australia
- Sarcoma and Surgical Research Centre, Chris O'Brien Lifehouse, Camperdown, NSW 2050, Australia
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2006, Australia
- Intelligent Polymer Research Institute, AIIM Facility, The University of Wollongong, Wollongong, NSW 2519, Australia
| | - David R McKenzie
- Arto Hardy Biomedical Innovation Hub, Chris O'Brien Lifehouse, Camperdown, NSW 2050, Australia
- Sarcoma and Surgical Research Centre, Chris O'Brien Lifehouse, Camperdown, NSW 2050, Australia
- School of Physics, Faculty of Science, The University of Sydney, Syndey, NSW 2006, Australia
| | - Qing Li
- School of Aerospace, Mechanical and Mechatronic Engineering, The University of Sydney, Darlington, NSW 2006, Australia
- Centre for Advanced Materials Technology, The University of Sydney, Darlington, NSW 2006, Australia
| | - Jonathan R Clark
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, NSW 2050, Australia
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2050, Australia
- Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, Camperdown, NSW 2050, Australia
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Ghosh YA, Xin H, Al Maruf DSA, Cheng K, Wise I, Burrows C, Gupta R, Cheung VKY, Wykes J, Leinkram D, Froggatt C, Lewin W, Kruse HV, Tomaskovic-Crook E, McKenzie DR, Crook J, Clark JR. Novel Sheep Model to Assess Critical-Sized Bone Regeneration with Periosteum for In Vivo Bioreactors. Tissue Eng Part C Methods 2024; 30:159-169. [PMID: 38368556 DOI: 10.1089/ten.tec.2023.0345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2024] Open
Abstract
Considerable research is being undertaken to develop novel biomaterials-based approaches for surgical reconstruction of bone defects. This extends to three-dimensional (3D) printed materials that provide stable, structural, and functional support in vivo. However, few preclinical models can simulate in vivo human biological conditions for clinically relevant testing. In this study we describe a novel ovine model that allows evaluation of in vivo osteogenesis via contact with bone and/or periosteum interfaced with printed polymer bioreactors loaded with biomaterial bone substitutes. The infraspinous scapular region of 14 Dorset cross sheep was exposed. Vascularized periosteum was elevated either attached to the infraspinatus muscle or separately. In both cases, the periosteum was supplied by the periosteal branch of the circumflex scapular vessels. In eight sheep, a 3D printed 4-chambered polyetheretherketone bioreactor was wrapped circumferentially in vascularized periosteum. In 6 sheep, 12 double-sided 3D printed 2-chambered polyetherketone bioreactors were secured to the underlying bone allowing direct contact with the bone on one side and periosteum on the other. Our model enabled simultaneous testing of up to 24 (12 double-sided) 10 × 10 × 5 mm bioreactors per scapula in the flat contact approach or a single 40 × 10 mm four-chambered bioreactor per scapula using the periosteal wrap. De novo bone growth was evaluated using histological and radiological analysis. Of importance, the experimental model was well tolerated by the animals and provides a versatile approach for comparing the osteogenic potential of cambium on the bone surface and elevated with periosteum. Furthermore, the periosteal flaps were sufficiently large for encasing bioreactors containing biomaterial bone substitutes for applications such as segmental mandibular reconstruction.
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Affiliation(s)
- Yohaann A Ghosh
- Department of Head & Neck Surgery, Chris O'Brien Lifehouse, Camperdown, Australia
- Sydney Medical School, The University of Sydney, Camperdown, Australia
- School of Medicine & Dentistry, Griffith University, Gold Coast, Australia
| | - Hai Xin
- Department of Head & Neck Surgery, Chris O'Brien Lifehouse, Camperdown, Australia
- Sydney Medical School, The University of Sydney, Camperdown, Australia
| | - D S Abdullah Al Maruf
- Department of Head & Neck Surgery, Chris O'Brien Lifehouse, Camperdown, Australia
- Sydney Medical School, The University of Sydney, Camperdown, Australia
| | - Kai Cheng
- Department of Head & Neck Surgery, Chris O'Brien Lifehouse, Camperdown, Australia
- Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, Australia
| | - Innes Wise
- Laboratory Animal Services, The University of Sydney, Camperdown, Australia
| | - Chris Burrows
- Laboratory Animal Services, The University of Sydney, Camperdown, Australia
| | - Ruta Gupta
- Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Camperdown, Australia
| | - Veronica Ka-Yan Cheung
- Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Camperdown, Australia
| | - James Wykes
- Department of Head & Neck Surgery, Chris O'Brien Lifehouse, Camperdown, Australia
- Sydney Medical School, The University of Sydney, Camperdown, Australia
| | - David Leinkram
- Department of Head & Neck Surgery, Chris O'Brien Lifehouse, Camperdown, Australia
| | - Catriona Froggatt
- Department of Head & Neck Surgery, Chris O'Brien Lifehouse, Camperdown, Australia
| | - Will Lewin
- Arto Hardy Family Biomedical Innovation Hub, Chris O'Brien Lifehouse, Camperdown, Australia
- Faculty of Medicine and Health, School of Medical Sciences, The University of Sydney, Camperdown, Australia
- Sarcoma and Surgical Research Centre, Chris O'Brien Lifehouse, Camperdown, Australia
| | - Hedi V Kruse
- Arto Hardy Family Biomedical Innovation Hub, Chris O'Brien Lifehouse, Camperdown, Australia
- Sarcoma and Surgical Research Centre, Chris O'Brien Lifehouse, Camperdown, Australia
- Faculty of Science, School of Physics, The University of Sydney, Camperdown, Australia
| | - Eva Tomaskovic-Crook
- Arto Hardy Family Biomedical Innovation Hub, Chris O'Brien Lifehouse, Camperdown, Australia
- Faculty of Medicine and Health, School of Medical Sciences, The University of Sydney, Camperdown, Australia
- Faculty of Science, School of Physics, The University of Sydney, Camperdown, Australia
| | - David R McKenzie
- Arto Hardy Family Biomedical Innovation Hub, Chris O'Brien Lifehouse, Camperdown, Australia
- Sarcoma and Surgical Research Centre, Chris O'Brien Lifehouse, Camperdown, Australia
- Faculty of Science, School of Physics, The University of Sydney, Camperdown, Australia
| | - Jeremy Crook
- Arto Hardy Family Biomedical Innovation Hub, Chris O'Brien Lifehouse, Camperdown, Australia
- Faculty of Medicine and Health, School of Medical Sciences, The University of Sydney, Camperdown, Australia
- Sarcoma and Surgical Research Centre, Chris O'Brien Lifehouse, Camperdown, Australia
- Faculty of Science, School of Physics, The University of Sydney, Camperdown, Australia
| | - Jonathan R Clark
- Department of Head & Neck Surgery, Chris O'Brien Lifehouse, Camperdown, Australia
- Sydney Medical School, The University of Sydney, Camperdown, Australia
- Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, Australia
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Charters E, Cheng K, Dunn M, Heng C, Loy J, Ricketts V, Luo A, Aung YM, Lewin W, Howes D, Manzie T, Wan B, Clark J. Restorabite™: Phase II trial of jaw stretching exercises using a novel device for patients with trismus following head and neck cancer. Int J Cancer 2024. [PMID: 38556848 DOI: 10.1002/ijc.34941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 02/05/2024] [Accepted: 02/21/2024] [Indexed: 04/02/2024]
Abstract
Patients treated for oral cancer, may experience restricted mouth opening (trismus). Barriers such as cost have limited the utilization of traditional jaw stretching devices, and consequently, patients experience problems with swallowing, oral care, communication, and cancer surveillance. The safety and efficacy of Restorabite™, a new device designed to overcome these barriers, is evaluated prospectively over 12 months. This phase II investigator-led trial included patients with chronic trismus underwent 10-weeks of trismus therapy using Restorabite™. Safety, adherence, changes in mouth opening, and patient-reported outcomes are presented. 114/120 participants with trismus completed the intervention, and 104 had their progress monitored for 12 months. Thirteen participants withdrew due to tumour recurrence. At the completion of the intervention, mouth opening improved by 10.4 mm (p < .001). This increased to 13.7 mm at 12 months (p < .001). Patient reported outcome all significantly improved and 47 participants were no longer classified as having trismus. There were no serious treatment related adverse events. In patients with trismus following head and neck cancer treatment, a 10-week programme of jaw stretching exercises using Restorbite™ safely improves mouth opening and associated quality of life outcomes with high adherence and the benefits are maintained for 12-months.
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Affiliation(s)
- Emma Charters
- Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Sydney, Australia
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Kai Cheng
- Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Sydney, Australia
- Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, Sydney, Australia
| | - Masako Dunn
- Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Sydney, Australia
| | - Caleb Heng
- Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Sydney, Australia
| | - Jamie Loy
- Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Sydney, Australia
| | - Virginia Ricketts
- Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Sydney, Australia
| | - Aaron Luo
- Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Sydney, Australia
| | - Yee Mon Aung
- Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Sydney, Australia
| | - Will Lewin
- Arto Hardy Family Biomedical Innovation Hub, Chris O'Brien Lifehouse, Sydney, Australia
| | - Dale Howes
- Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Sydney, Australia
- University of Sydney Dental School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Timothy Manzie
- Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Sydney, Australia
- Sydney Medical School, Faculty of Medicine and Health Sciences, The University of Sydney, Sydney, Australia
| | - Boyang Wan
- School of Aerospace, Mechanical and Mechatronic Engineering, Faculty of Engineering, The University of Sydney, Sydney, Australia
| | - Jonathan Clark
- Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Sydney, Australia
- Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, Sydney, Australia
- Sydney Medical School, Faculty of Medicine and Health Sciences, The University of Sydney, Sydney, Australia
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Patfield A, Wykes J, Venchiarutti R, Dunn M, Clark J, Froggatt C. How age affects health-related-quality-of-life outcomes in maxillomandibular reconstructive surgery. ANZ J Surg 2024; 94:148-155. [PMID: 38156723 DOI: 10.1111/ans.18826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 11/02/2023] [Accepted: 12/04/2023] [Indexed: 01/03/2024]
Abstract
INTRODUCTION Maxillomandibular reconstruction has various functional, aesthetic, and psychosocial effects that can decrease patients' health-related quality of life (HRQOL). The aim of this study was to compare HRQOL outcomes in older and younger patients undergoing maxillomandibular reconstruction. METHODS A cross-sectional study of patients undergoing maxillomandibular reconstruction surgery between November 2008 and January 2021 was conducted. Participants completed the FACE-Q Head and Neck Cancer Module, M.D. Anderson Dysphagia Inventory (MDADI), and Speech Handicap Index (SHI). Results from these instruments were used to compare HRQOL outcomes in old (≥70 years) and young (<70 years) patients. RESULTS Ninety-nine patients who underwent maxillomandibular reconstruction completed the instruments (response rate 50%), of which 33 (33%) were aged ≥70 years. Older age was associated with improved FACE-Q speaking (+11.3, P = 0.045), FACE-Q cancer worry (-9.97, P = 0.050), and SHI score (-16.6, P = 0.013). After adjusting for the effect of radiotherapy, age was associated with improved FACE-Q speaking (+16.8, P = 0.012), FACE-Q smiling distress (+12.6, P = 0.040), FACE-Q worry (-11.0, P = 0.032), and SHI scores (-18.4, P = 0.004). Older age was associated with an increased likelihood of postoperative complications (odds ratio (OR) = 2.9, P = 0.02) and medical complications (OR = 4.6, P = 0.012). CONCLUSION In patients undergoing maxillomandibular reconstruction, older age (≥70 years) was associated with better HRQOL outcomes in domains relating to speech and cancer worry. In all other HRQOL outcomes, the two age groups performed similarly.
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Affiliation(s)
- Alexander Patfield
- Faculty of Medicine and Health, The University of New South Wales, Sydney, New South Wales, Australia
| | - James Wykes
- Department of Head and Neck Surgery, Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Rebecca Venchiarutti
- Department of Head and Neck Surgery, Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Masako Dunn
- Department of Head and Neck Surgery, Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia
| | - Jonathan Clark
- Department of Head and Neck Surgery, Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, Camperdown, New South Wales, Australia
| | - Catriona Froggatt
- Department of Head and Neck Surgery, Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia
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Mendis RL, Leinkram D, Manzie T, Clark JR. Use of Kirschner wires to assist with plate alignment in jaw reconstruction. Br J Oral Maxillofac Surg 2023; 61:711-712. [PMID: 37866973 DOI: 10.1016/j.bjoms.2023.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 09/22/2023] [Indexed: 10/24/2023]
Affiliation(s)
- Rajith L Mendis
- Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Camperdown, NSW, Australia.
| | - David Leinkram
- Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Camperdown, NSW, Australia
| | - Timothy Manzie
- Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Camperdown, NSW, Australia; Central Clinical School, Faculty of Medicine and Health Sciences, The University of Sydney, NSW, Australia
| | - Jonathan R Clark
- Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Camperdown, NSW, Australia; Central Clinical School, Faculty of Medicine and Health Sciences, The University of Sydney, NSW, Australia; The Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, Camperdown, NSW, Australia
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7
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Ma J, Aung YM, Manzie T, Cheng K, Dunn M, Mukherjee P, Clark J. Clinical application of 3-dimensional tissue volume assessment using CloudCompare. Br J Oral Maxillofac Surg 2023; 61:567-570. [PMID: 37604759 DOI: 10.1016/j.bjoms.2023.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 07/24/2023] [Accepted: 07/31/2023] [Indexed: 08/23/2023]
Abstract
Adjunctive procedures, including autologous fat grafting and surgical debulking, may be required to optimise facial contours following maxillomandibular reconstruction. A standardised method for the quantitative analysis of volumetric change and the impact of restoration of facial symmetry on health-related quality of life remains unclear. We use two case studies to illustrate the value of a combination of objective 3-dimenmsional (3D) measurements, clinical assessments, and patient-reported outcomes, using the FACE-Q questionnaire to elucidate the benefits of adjunctive procedures.
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Affiliation(s)
- Jolande Ma
- Department of Head and Neck Surgery, Chris O'Brien Lifehouse, 119-143 Missenden Road, Camperdown, NSW 2050, Australia; Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Anderson Stuart Building, Camperdown, NSW 2006, Australia.
| | - Yee Mon Aung
- Department of Head and Neck Surgery, Chris O'Brien Lifehouse, 119-143 Missenden Road, Camperdown, NSW 2050, Australia
| | - Timothy Manzie
- Department of Head and Neck Surgery, Chris O'Brien Lifehouse, 119-143 Missenden Road, Camperdown, NSW 2050, Australia
| | - Kai Cheng
- Department of Head and Neck Surgery, Chris O'Brien Lifehouse, 119-143 Missenden Road, Camperdown, NSW 2050, Australia; Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, 145 Missenden Road, Camperdown, NSW 2050, Australia
| | - Masako Dunn
- Department of Head and Neck Surgery, Chris O'Brien Lifehouse, 119-143 Missenden Road, Camperdown, NSW 2050, Australia
| | - Payal Mukherjee
- Department of Head and Neck Surgery, Chris O'Brien Lifehouse, 119-143 Missenden Road, Camperdown, NSW 2050, Australia; Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Anderson Stuart Building, Camperdown, NSW 2006, Australia; Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, 145 Missenden Road, Camperdown, NSW 2050, Australia
| | - Jonathan Clark
- Department of Head and Neck Surgery, Chris O'Brien Lifehouse, 119-143 Missenden Road, Camperdown, NSW 2050, Australia; Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Anderson Stuart Building, Camperdown, NSW 2006, Australia; Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, 145 Missenden Road, Camperdown, NSW 2050, Australia
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Kawasaki M, Ogino Y, Moroi R, Ayukawa Y. Comprehensive Analyses of Masticatory Function in Maxillectomy Patients with Functioning Removable Prostheses: A Retrospective Cross-Sectional Study. J Clin Med 2023; 12:5117. [PMID: 37568519 PMCID: PMC10419695 DOI: 10.3390/jcm12155117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 08/02/2023] [Accepted: 08/03/2023] [Indexed: 08/13/2023] Open
Abstract
The aim of this retrospective cross-sectional study was to comprehensively assess masticatory function in maxillectomy patients with functioning removable prostheses. Their general and oral profiles, the measurement values of their oral functions, including masticatory function, and the history of tumor therapy were extracted from medical charts. The correlations of masticatory function with numerical data and the effects of tumor therapy-related factors on masticatory function were evaluated. In addition, a stepwise conditional logistic regression analysis was performed to identify the potential predictive factors comprehensively. The data from 55 maxillectomy patients revealed that the median value of masticatory function (138.0 mg/dL) was higher than the threshold (100.0 mg/dL) based on the concept of oral hypofunction. Moderate correlations of masticatory function with the number of remaining teeth, the number of functioning occlusal supports, and maximum occlusal force were found, as well as a weak correlation with maximum tongue pressure. These variables also showed statistically significant coefficients (p < 0.01). No significant effect of each tumor therapy-related factor on masticatory function was detected. A logistic regression analysis identified the number of functioning occlusal supports as a significant predictive factor. These results implied the crucial interactions of masticatory function with various factors and the specificities of maxillectomy patients.
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Affiliation(s)
- Masahiro Kawasaki
- Section of Fixed Prosthodontics, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka 812-8582, Japan; (M.K.); (R.M.); (Y.A.)
| | - Yoichiro Ogino
- Section of Fixed Prosthodontics, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka 812-8582, Japan; (M.K.); (R.M.); (Y.A.)
| | - Ryoji Moroi
- Section of Fixed Prosthodontics, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka 812-8582, Japan; (M.K.); (R.M.); (Y.A.)
| | - Yasunori Ayukawa
- Section of Fixed Prosthodontics, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka 812-8582, Japan; (M.K.); (R.M.); (Y.A.)
- Section of Implant and Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka 812-8582, Japan
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9
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Xin H, Romanazzo S, Tomaskovic-Crook E, Mitchell TC, Hung JC, Wise SG, Cheng K, Al Maruf DSA, Stokan MJ, Manzie TGH, Parthasarathi K, Cheung VKY, Gupta R, Ly M, Pulitano C, Wise IK, Crook JM, Clark JR. Ex Vivo Preservation of Ovine Periosteum Using a Perfusion Bioreactor System. Cells 2023; 12:1724. [PMID: 37443758 PMCID: PMC10340137 DOI: 10.3390/cells12131724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/16/2023] [Accepted: 06/20/2023] [Indexed: 07/15/2023] Open
Abstract
Periosteum is a highly vascularized membrane lining the surface of bones. It plays essential roles in bone repair following injury and reconstruction following invasive surgeries. To broaden the use of periosteum, including for augmenting in vitro bone engineering and/or in vivo bone repair, we have developed an ex vivo perfusion bioreactor system to maintain the cellular viability and metabolism of surgically resected periosteal flaps. Each specimen was placed in a 3D printed bioreactor connected to a peristaltic pump designed for the optimal flow rates of tissue perfusate. Nutrients and oxygen were perfused via the periosteal arteries to mimic physiological conditions. Biochemical assays and histological staining indicate component cell viability after perfusion for almost 4 weeks. Our work provides the proof-of-concept of ex vivo periosteum perfusion for long-term tissue preservation, paving the way for innovative bone engineering approaches that use autotransplanted periosteum to enhance in vivo bone repair.
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Affiliation(s)
- Hai Xin
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2050, Australia
| | - Sara Romanazzo
- Arto Hardy Family Biomedical Innovation Hub, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia
| | - Eva Tomaskovic-Crook
- Arto Hardy Family Biomedical Innovation Hub, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Intelligent Polymer Research Institute, University of Wollongong, Innovation Campus, Squires Way, North Wollongong, NSW 2500, Australia
| | - Timothy C. Mitchell
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Jui Chien Hung
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Steven G. Wise
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Kai Cheng
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia
- Royal Prince Alfred Institute of Academic Surgery, Royal Prince Alfred Hospital, Sydney Local Health District, Camperdown, NSW 2050, Australia
| | - D S Abdullah Al Maruf
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2050, Australia
| | - Murray J. Stokan
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia
| | - Timothy G. H. Manzie
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia
| | - Krishnan Parthasarathi
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia
| | - Veronica K. Y. Cheung
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2050, Australia
- The Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia
| | - Ruta Gupta
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2050, Australia
- The Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia
| | - Mark Ly
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2050, Australia
- RPA Translational Center for Organ Assessment, Repair, and Optimization, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia
| | - Carlo Pulitano
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2050, Australia
- RPA Translational Center for Organ Assessment, Repair, and Optimization, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia
| | - Innes K. Wise
- Laboratory Animal Services, Charles Perkins Center, The University of Sydney, Camperdown, NSW 2050, Australia
| | - Jeremy M. Crook
- Arto Hardy Family Biomedical Innovation Hub, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Intelligent Polymer Research Institute, University of Wollongong, Innovation Campus, Squires Way, North Wollongong, NSW 2500, Australia
| | - Jonathan R. Clark
- Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O’Brien Lifehouse, Camperdown, NSW 2050, Australia
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2050, Australia
- Royal Prince Alfred Institute of Academic Surgery, Royal Prince Alfred Hospital, Sydney Local Health District, Camperdown, NSW 2050, Australia
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10
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Tumuluri V, Leinkram D, Froggatt C, Dunn M, Wykes J, Singh J, Low T(H, Palme CE, Howes D, Clark JR. Outcomes of immediate dental implants in vascularised bone flaps for mandibular reconstruction. ANZ J Surg 2023; 93:1682-1687. [PMID: 37026415 PMCID: PMC10953371 DOI: 10.1111/ans.18427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 01/14/2023] [Accepted: 03/13/2023] [Indexed: 04/08/2023]
Abstract
BACKGROUND The aim of this study is to assess the outcomes of immediate implant placement for dental rehabilitation following mandibular reconstruction with vascularised bone flaps in a single Australian tertiary cancer centre. METHODS A retrospective analysis of patients who underwent immediate dental implant or delayed placement in vascularised bone flaps was performed. Primary outcome measures assessed included the number of implants placed, operative time, complication rates, time to radiotherapy initiation, dental rehabilitation rates and time to dental rehabilitation. RESULTS In total, 187 dental implants were placed in 52 patients, of which 34 patients underwent immediate implant placement and 18 had delayed implant placement. There were no significant differences in the postoperative complication rate (32% immediate vs. 33% delayed, P = 0.89) or time to postoperative radiotherapy (median 42 days immediate vs. 47 days delayed, P = 0.24). Dental rehabilitation was achieved in 62% of the immediate cohort versus 78% of the delayed cohort. The time to be fitted with a dental prosthesis was significantly shorter in the immediate cohort (median 150 days immediate vs. 843 days delayed, P = 0.002). CONCLUSIONS The placement of immediate dental implants at the time of primary reconstruction of the mandible is a safe procedure and facilitates timely dental rehabilitation.
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Affiliation(s)
- Vinay Tumuluri
- Faculty of Health and Medical Sciences, School of DentistryUniversity of AdelaideAdelaideAustralia
| | - David Leinkram
- Department of Head and Neck SurgerySydney Head and Neck Cancer Institute, Chris O'Brien LifehouseSydneyNew South WalesAustralia
| | - Catriona Froggatt
- Department of Head and Neck SurgerySydney Head and Neck Cancer Institute, Chris O'Brien LifehouseSydneyNew South WalesAustralia
| | - Masako Dunn
- Department of Head and Neck SurgerySydney Head and Neck Cancer Institute, Chris O'Brien LifehouseSydneyNew South WalesAustralia
| | - James Wykes
- Department of Head and Neck SurgerySydney Head and Neck Cancer Institute, Chris O'Brien LifehouseSydneyNew South WalesAustralia
- Sydney Medical School, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
| | - Jasvir Singh
- Department of Head and Neck SurgerySydney Head and Neck Cancer Institute, Chris O'Brien LifehouseSydneyNew South WalesAustralia
| | - Tsu‐Hui (Hubert) Low
- Department of Head and Neck SurgerySydney Head and Neck Cancer Institute, Chris O'Brien LifehouseSydneyNew South WalesAustralia
- Sydney Medical School, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
- Royal Prince Alfred Institute of Academic SurgerySydney Local Health DistrictSydneyNew South WalesAustralia
- Department of Otolaryngology – Head & Neck Surgery, Faculty of Medicine and Health SciencesMacquarie UniversitySydneyNew South WalesAustralia
| | - Carsten E. Palme
- Department of Head and Neck SurgerySydney Head and Neck Cancer Institute, Chris O'Brien LifehouseSydneyNew South WalesAustralia
- Sydney Medical School, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
| | - Dale Howes
- Department of Head and Neck SurgerySydney Head and Neck Cancer Institute, Chris O'Brien LifehouseSydneyNew South WalesAustralia
- Sydney Dental School, Faculty of Medicine and HealthThe University of SydneySydneyAustralia
| | - Jonathan R. Clark
- Department of Head and Neck SurgerySydney Head and Neck Cancer Institute, Chris O'Brien LifehouseSydneyNew South WalesAustralia
- Sydney Medical School, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
- Royal Prince Alfred Institute of Academic SurgerySydney Local Health DistrictSydneyNew South WalesAustralia
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11
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Venchiarutti RL, Charters EK, Dunn M, Clark JR. Construct and discriminant validity testing of the FACE-Q Head and Neck Cancer Module for assessing speech and swallowing outcomes for patients undergoing maxillectomy or mandibulectomy. Head Neck 2023; 45:1519-1529. [PMID: 37052459 DOI: 10.1002/hed.27366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 03/21/2023] [Accepted: 03/27/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND The FACE-Q H&N is a patient reported outcome measure covering multiple constructs for patients with head and neck tumors. Additional testing is needed to determine suitability in assessing speech- and swallowing-related quality of life and function. METHODS FACE-Q H&N, The M. D. Anderson Dysphagia Inventory (MDADI), and Speech Handicap Index (SHI) scores were collected from two patient cohorts who had undergone jaw reconstruction. Construct validity was assessed using convergent validity testing and known groups testing to assess discriminant validity. RESULTS A priori hypotheses testing demonstrated strong correlations (ρ > 0.6, p < 0.05) between FACE-Q H&N eating and drinking, swallowing and eating distress scales with MDADI subscales, and between FACE-Q H&N speech function and distress scales and the SHI. Known groups testing demonstrated all instruments could delineate outcomes among patients who had radiation, advanced tumors, and tracheostomy. CONCLUSION The FACE-Q H&N may be an alternative for the SHI and MDADI in this patient cohort.
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Affiliation(s)
- Rebecca L Venchiarutti
- Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
- Faculty of Medicine and Health, Sydney School of Public Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Emma K Charters
- Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Camperdown, New South Wales, Australia
| | - Masako Dunn
- Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
| | - Jonathan R Clark
- Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
- Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Camperdown, New South Wales, Australia
- Royal Prince Alfred Institute of Academic Surgery, Camperdown, New South Wales, Australia
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12
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Manzie T, MacDougall H, Cheng K, Venchiarutti R, Fox R, Sharman A, Charters E, Seyfi D, Dunn M, Mukherjee P, Clark J. Virtual reality digital surgical planning for jaw reconstruction: a usability study. ANZ J Surg 2023; 93:1341-1347. [PMID: 36792539 DOI: 10.1111/ans.18307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/17/2023] [Accepted: 01/22/2023] [Indexed: 02/17/2023]
Abstract
BACKGROUND Digital surgical planning (DSP) has revolutionized the preparation and execution of the management of complex head and neck pathologies. The addition of virtual reality (VR) allows the surgeon to have a three-dimensional experience with six degrees of freedom for visualizing and manipulating objects. This pilot study describes the participants experience with the first head and neck reconstructive VR-DSP platform. METHODS An original VR-DSP platform has been developed for planning the ablation and reconstruction of head and neck pathologies. A prospective trial utilizing this platform involving reconstructive surgeons was performed. Participants conducted a simulated VR-DSP planning session, pre- and post-questionnaire as well as audio recordings allowing for qualitative analysis. RESULTS Thirteen consultant reconstructive surgeons representing three surgical backgrounds with varied experience were recruited. The majority of surgeons had no previous experience with VR. Based on the system usability score, the VR-DSP platform was found to have above average usability. The qualitative analysis demonstrated the majority had a positive experience. Participants identified some perceived barriers to implementing the VR-DSP platform. CONCLUSIONS Virtual reality-digital surgical planning is usable and acceptable to reconstructive surgeons. Surgeons were able to perform the steps in an efficient time despite limited experience. The addition of VR offers additional benefits to current VSP platforms. Based on the results of this pilot study, it is likely that VR-DSP will be of benefit to the reconstructive surgeon.
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Affiliation(s)
- Timothy Manzie
- Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia
| | - Hamish MacDougall
- Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, Sydney, New South Wales, Australia
| | - Kai Cheng
- Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia.,Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, Sydney, New South Wales, Australia
| | - Rebecca Venchiarutti
- Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia.,Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | | | - Ashleigh Sharman
- Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia
| | - Emma Charters
- Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia.,Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Doruk Seyfi
- Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia
| | - Masako Dunn
- Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia
| | - Payal Mukherjee
- Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia.,Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, Sydney, New South Wales, Australia
| | - Jonathan Clark
- Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia.,Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, Sydney, New South Wales, Australia.,Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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13
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Wang LM, Tian YY, Liu XM, Cao Y, Sui L, Mao C, Liu H, Ye JH, Zhou YS, Peng X, Ye HQ, Yan YB. Quality of life in patients with cancer-related Brown IIb maxillary defect: A comparison between conventional obturation rehabilitation and submental flap reconstruction. Oral Oncol 2022; 132:105980. [PMID: 35749804 DOI: 10.1016/j.oraloncology.2022.105980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 05/17/2022] [Accepted: 06/17/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVES The purpose of this retrospective study was to compare the differences in quality of life (QOL) outcomes between the conventional obturator prostheses (COP) and the pedicled submental artery island flap (SAIF) in the reconstruction of Brown IIb maxillary defects. MATERIALS AND METHODS The QOL of 116 eligible patients who had a lapse ≥ 12 months after the cancer-related maxilla ablation was evaluated by the University of Washington quality of life scale (UW-QOL), Performance Status Scale for Head and Neck (PSS-HN), and Obturator Functioning Scale (OFS). RESULTS Patients in the SAIF group reported statistically and clinically significant higher overall QOL scores but lower chewing scores in the UW-QOL scale when compared with those in the COP group (P < 0.05). Clinically significantly higher scores were also observed in the recreation and anxiety domains in the UW-QOL scale for the SAIF group, but there was no statistical significances. The COP group reported more complaints about the nasal leakage when swallowing and the shape of the upper lip, and had a stronger willingness to avoid family or social events in the OFS (P < 0.05). CONCLUSIONS For patients with Brown IIb defects, SAIF reconstruction can achieve reduced nasal leakage when swallowing, improved upper-lip contour, increased social activity, and superior overall QOL than COP. The inferior chewing function in the SAIF group indicated the need for dental rehabilitation with a conventional denture or osseointegrated implants.
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Affiliation(s)
- Li-Mei Wang
- Tianjin Medical University, 22 Qi-xiang-tai Road, Heping District, Tianjin 300070, PR China
| | - Yuan-Yuan Tian
- Department of Oromaxillofacial-Head and Neck Surgery, Tianjin Stomatological Hospital, 75 Dagu Road, Heping District, Tianjin 300041, PR China; Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, 75 Dagu Road, Heping District, Tianjin 300041, PR China
| | - Xiao-Ming Liu
- Department of Prosthodontics, Tianjin Stomatological Hospital, 75 Dagu Road, Heping District, Tianjin 300041, PR China
| | - Ye Cao
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing 100081, PR China
| | - Lei Sui
- Department of Prosthodontics, Stomatological Hospital of Tianjin Medical University, 22 Qi-xiang-tai Road, Heping District, Tianjin 300070, PR China
| | - Chi Mao
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing 100081, PR China
| | - Hao Liu
- Department of Oromaxillofacial-Head and Neck Surgery, Tianjin Stomatological Hospital, 75 Dagu Road, Heping District, Tianjin 300041, PR China; Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, 75 Dagu Road, Heping District, Tianjin 300041, PR China
| | - Jia-Hui Ye
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing 100081, PR China
| | - Yong-Sheng Zhou
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing 100081, PR China
| | - Xin Peng
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing 100081, PR China.
| | - Hong-Qiang Ye
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing 100081, PR China.
| | - Ying-Bin Yan
- Department of Oromaxillofacial-Head and Neck Surgery, Tianjin Stomatological Hospital, 75 Dagu Road, Heping District, Tianjin 300041, PR China; Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, 75 Dagu Road, Heping District, Tianjin 300041, PR China.
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