Tesis

Hubungan Karakteristik Klinis Dengan Fungsi Pascarekonstruksi Mandibula Menggunakan Flap Fibula Bebas = Association of Clinical Characteristics with Functional Outcomes Following Mandibular Reconstruction With Free Fibula Flap.

Introduksi: Rekonstruksi mandibula pada kasus-kasus tumor mandibula menggunakan flap fibula bebas merupakan hal penting untuk mengembalikan fungsi dan estetik pada defek pascareseksi. Penelitian ini ditujukan untuk menilai hubungan karakteristik klinis dengan fungsi menelan, fungsi bicara, fungsi makan, dan kualitas hidup pada pasien yang dilakukan rekonstruksi mandibula menggunakan flap fibula bebas pascamandibulektomi. Metode: Dilakukan studi dengan desain potong lintang dan survei mengikutsertakan pasien yang dilakukan rekonstruksi mandibula menggunakan flap fibula bebas pascamandibulektomi di RSCM pada tahun 2014-2019. Dilakukan penilaian terhadap kelas defek mandibula, panjang defek, jumlah subunit mandibula, ekstensi defek, jumlah segmen tulang, selanjutnya dilakukan penilaian fungsi melalui wawancara menggunakan European Organization for Research and Treatment of Cancer Head and Neck Cancer Quality of Life Questionnaire (EORTC QLQ-H&N35). Hasil: Tercatat 63 pasien dengan mandibulektomi dan dilakukan rekonstruksi. Hanya 14 dapat dinilai. Hanya panjang defek dan ekstensi defek yang memiliki hubungan bermakna dengan fungsi. Panjang defek mandibula memiliki korelasi positif dengan gangguan pada fungsi menelan (p = 0,032), fungsi bicara (p = 0,020), dan kualitas hidup (p = 0,032). Ekstensi defek intraoral dan ekstraoral menyebabkan gangguan fungsi menelan (p = 0,035). Konklusi: Penelitian ini menunjukkan bahwa fungsi menelan, fungsi bicara, dan kualitas hidup tergantung defek pascamandibulektomi.
Kata kunci: Rekonstruksi mandibula, flap fibula bebas, karakteristik klinis, fungsi menelan, fungsi bicara, fungsi makan, kualitas hidup


Introduction: Mandibular reconstruction utilizing free fibula flap is essential in restoring the function, and aesthetics outcomes post mandibular tumor resection. This study looks into the association of clinical characteristics with functional outcomes such as swallowing, speaking, eating, and quality of life on patients undergoing post-mandibulectomy mandibular reconstruction using free fibula flap. Methods: We performed a cross-sectional study that includes patients who underwent post-mandibulectomy mandibular reconstruction using free fibula flap at RSCM in 2014-2019. Mandibula defect class, defect length, the number of mandibula subunits, defect extension, and the number of osteotomy segments was evaluated. The functional outcomes were assessed using the European Organization for Research and Treatment of Cancer Head and Neck Cancer Quality of Life Questionnaire (EORTC QLQ-H&N35). Results: 63 patients underwent mandibulectomy and reconstruction using free fibula flap. Only 14 were included in the study. Defect length and extension are significantly associated with functional outcomes. Mandibula defect length has positive correlation with problems in swallowing function (p = 0.032), speaking function (p = 0.020), and quality of life (p = 0.032). Both intraoral and extraoral defect extension causes swallowing function problem (p = 0.035). Conclusion: This study discovered that swallowing function, speaking function, and quality of life are associated with post-mandibulectomy defect.
Key words: Mandibular reconstruction, free fibula flap, clinical characteristics, swallowing function, speaking function, eating function, quality of life