Clinical Outcomes of Thoracodorsal Artery Flap in Oral and Maxillofacial Reconstruction

Condition(s) studied

Investigational drug(s) / intervention(s)

Thoracodorsal artery perforator flap reconstruction surgery: Oral squamous cell carcinoma patients underwent reconstruction with thoracodorsal artery perforator (TDAP) flaps following tumor resection.

Forearm flaps reconstruction surgery: Oral squamous cell carcinoma patients received the reconstruction with forearm flaps after tumor resection

Anterolateral thigh flap reconstruction surgery: Oral squamous cell carcinoma patients received the reconstruction with anterolateral thigh flaps after tumor resection

Fibula flap reconstruction surgery: Oral squamous cell carcinoma patients received the reconstruction with fibula flaps after tumor resection

Forearm flap reconstruction surgery: Oral squamous cell carcinoma patients received the reconstruction with forearm flaps after tumor resection

Study summary

The goal of this study is to retrospectively compare different types of free flaps to determine the most suitable free flap for functional reconstruction in oral squamous cell carcinoma patients following tumor resection. The main questions it aims to answer are:

Do the clinical characteristics of the thoracodorsal artery perforator flap differ from those of other types of flaps? Does the thoracodorsal artery perforator flap result in better clinical outcomes compared to other types of flaps? After reconstruction with the thoracodorsal artery perforator flap, do patients have better quality of life, speech function and scar healing compared to other types of flaps? Investigators will retrospectively compare the thoracodorsal artery perforator flap with other types of flaps (such as the anterolateral thigh flap, forearm flap, latissimus dorsi flap and fibula flap) to explore the most suitable free flap for facial defect reconstruction in oral squamous cell carcinoma patients.

Participants are oral squamous cell carcinoma patients who previously underwent facial defect reconstruction with different types of flaps. Participants have completed relevant questionnaires at 1, 3, 6 and 12 months post-surgery. The data will be scored and assessed by the investigators.

Eligibility

Primary outcome measure(s)

• Postoperative Quality of Life — Postoperative at 1, 3, 6, and 12 months
  The investigators applied the University of Washington Quality of Life (UW-QOL) questionnaire to evaluate the participants' appearance, functional outcomes and emotional well-being. This included scores for pain, appearance, activity, comfort, swallowing, chewing, speech, shoulder function, taste, saliva, emotion, anxiety and the overall total score. According to the UW-QOL version 4 questionnaire, each domain is scored on a scale from 0 to 100, with higher scores indicating a better quality of life.
• Postoperative Speech Function — Postoperative at 1, 3, 6, and 12 months
  The investigators evaluated postoperative speech function using the 30-item Speech Handicap Index (SPI) questionnaire. This questionnaire employs a 5-point Likert scale with the following response categories: "never" (0 points), "almost never" (1 point), "sometimes" (2 points), "almost always" (3 points), and "always" (4 points). The total SPI score ranges from 0 to 120 and includes two subscales: psychosocial function and speech function, each consisting of 14 items. Lower scores indicate better speech function.
• Scar Assessment — Postoperative at 1, 3, 6, and 12 months
  The investigators applied the Vancouver Scar Scale (VSS) questionnaire to evaluate the participants' scars at the donor site. This included scores for the pigmentation (score from 0-3), thickness (score from 0-3), blood supply (score from 0-5) and texture (score from 0-3) of the scar at donor site. According to the VSS questionnaire, a lower score indicates a better outcome with the similar appearance like normal, however a higher score indicates an abnormal appearance and contracture.
• Swallowing Function Assessment — Postoperative at 1, 3, 6, and 12 months
  The investigators applied the NIH Swallowing Safety Scale (NIH-SSS) questionnaire to evaluate the participants' swallowing function. The total score of NIH-SSS ranges from 0 to 10 points, with each score reflecting a different level of swallowing safety. A score of 0 indicates completely safe swallowing with no signs of aspiration or difficulty, while a score of 10 represents the most severe aspiration or swallowing impairment, potentially requiring urgent intervention.

Trial sites (1)

More Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University trials in China

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