Évaluation fonctionnelle des reconstructions mandibulaires par lambeaux libres osseux dans l’Océan Indien
Year: 2025
Type: dissertation
Study design: Observational Study
Abstract: Introduction: This study aimed to evaluate the functional outcomes of mandibular reconstruction with free bone flaps, focusing on swallowing, voice, and speech, in patients from Réunion Island.Materials and Methods: We conducted a retrospective study of 62 patients who underwent mandibular reconstruction with free bone flaps between 2009 and 2024 in Réunion. Functional outcomes were assessed at least six months postoperatively using a standardized questionnaire that collected patient characteristics, three self-assessment tools, and an evaluation by a speech therapist. The main outcomes included resumption of oral feeding, impact on swallowing and speech intelligibility (assessed via DHI, VHI, and SHI scores), and dependence on gastrostomy. Statistical analysis included univariate and bivariate analyses.Results: All 62 patients underwent mandibular reconstruction using fibula free flaps, with a primary success rate of 90%. Early complications were common. Fifteen patients received prosthetic or implant rehabilitation. Complete functional evaluation was available for 21 patients. Of these, 95% had resumed oral feeding, and speech intelligibility was rated as average or good in 90% of cases. No significant associations were found between radiotherapy, tongue resection, and swallowing function, likely due to limited statistical power.Conclusion: Mandibular reconstruction with free bone flaps enables most patients to resume oral feeding, with minimal impact on swallowing and speech. Optimizing surgical and rehabilitative practices may reduce complications and facilitate more systematic dental rehabilitation.
Source: HAL
Author: Leroy, Chloé
Institution: University of Reunion Island
Language: French
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7113686538