Evaluation of the Deviation pattern following Mandibulectomy for Oral Cancer Patients - A Prospective Study

Post-mandibulectomy rehabilitation involves a multidisciplinary approach which includes surgical reconstruction with bone/ reconstruction plate, the use of guide bite prosthesis and dental rehabilitation, and physical therapy depending on the clinical situation and patients’ individual needs.

Research gap:  Since patients with segmental mandibulectomy defect and soft tissue reconstruction represent a major cohort of mandibulectomy patients and no literature is present describing the amount of mandibular deviation in these patients, its correlation with the extent of the size of the surgical defect, type of soft tissue reconstruction, period elapsed from the surgery, and adjuvant treatment, use of guidance prosthesis. No guidance literature is present regarding how much time the guidance prosthesis should be used in these mandibulectomy patients. Prospective clinical studies can provide valuable insights into this complication’s prevalence, severity, and potential predictors.

The study aims to evaluate the Deviation pattern following Mandibulectomy for Oral Cancer Patients.

The primary objective is to measure the deviation pattern following mandibulectomy for oral cancer patients reconstructed with soft tissue flap.

All patients who are planning to undergo mandibulectomy for oral cancer will be eligible to participate in this study. Patient demographics including age, stage, treatment details of the surgery, reconstruction details, adjuvant radiotherapy, and/or chemotherapy will be retrieved from the case records and/or EMR. Hospital-based “Electronic Medical Record” will be reviewed to enter the clinical details.

Outcome evaluation would quantify the degree of deviation in millimeters and assess the prevalence and severity of mandibular deviation at various time intervals following surgery and will be compared with the baseline data before surgery. The deviations will be compared based on factors like the extent of the defect, radiation treatment, and prosthesis use. Chewing performance would be evaluated by the mixing ability. The chewing efficiency of study participants will be evaluated and compared between different subgroups based on the mentioned factors. The Quality of life would be evaluated by the EORTC QLQ-C30 and H&N35 questionnaires.  The outcome would assess the impact of mandibular deviation on the overall quality of life of participants and analyze differences in quality of life scores based on the time elapsed since surgery, the extent of the defect, radiation treatment, and prosthesis use. The outcome would also analyze the effect of guide bite prosthesis usage on mandibular deviation, chewing efficiency, and quality of life by comparing outcomes between users at different time points.

By measuring these outcomes and considering the mentioned factors, this study can provide valuable insights into how mandibular deviation impacts patients’ lives and how various factors influence this deviation, chewing efficiency, and overall quality of life following mandibulectomy.