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Quality of life of maxillectomy patients using an obturator prosthesis

1996; Wiley; Volume: 18; Issue: 4 Linguagem: Inglês

10.1002/(sici)1097-0347(199607/08)18

1097-0347

Alice B. Kornblith, Ian M. Zlotolow, Jane Gooen, Joseph M. Huryn, Todd Lerner, Elliót W. Strong, Jatin P. Shah, Ronald H. Spiro, Jimmie C. Holland,

Pelvic and Acetabular Injuries

Head & NeckVolume 18, Issue 4 p. 323-334 Quality of life of maxillectomy patients using an obturator prosthesis Alice B. Kornblith PhD, Corresponding Author Alice B. Kornblith PhD Psychiatry Service, Memorial Sloan-Kettering Cancer Center, New York City; Dental Service, Department of Surgery, MSKCC; and Head and Neck Service, Department of Surgery, MSKCC.Psychiatry Service, Box 266, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021Search for more papers by this authorIan M. Zlotolow DMD, Ian M. Zlotolow DMD Psychiatry Service, Memorial Sloan-Kettering Cancer Center, New York City; Dental Service, Department of Surgery, MSKCC; and Head and Neck Service, Department of Surgery, MSKCC.Search for more papers by this authorJane Gooen MA, Jane Gooen MA Psychiatry Service, Memorial Sloan-Kettering Cancer Center, New York City; Dental Service, Department of Surgery, MSKCC; and Head and Neck Service, Department of Surgery, MSKCC.Search for more papers by this authorJoseph M. Huryn DDS, Joseph M. Huryn DDS Psychiatry Service, Memorial Sloan-Kettering Cancer Center, New York City; Dental Service, Department of Surgery, MSKCC; and Head and Neck Service, Department of Surgery, MSKCC.Search for more papers by this authorTodd Lerner DDS, Todd Lerner DDS Psychiatry Service, Memorial Sloan-Kettering Cancer Center, New York City; Dental Service, Department of Surgery, MSKCC; and Head and Neck Service, Department of Surgery, MSKCC.Search for more papers by this authorElliot W. Strong MD, Elliot W. Strong MD Psychiatry Service, Memorial Sloan-Kettering Cancer Center, New York City; Dental Service, Department of Surgery, MSKCC; and Head and Neck Service, Department of Surgery, MSKCC.Search for more papers by this authorJatin P. Shah MD, Jatin P. Shah MD Psychiatry Service, Memorial Sloan-Kettering Cancer Center, New York City; Dental Service, Department of Surgery, MSKCC; and Head and Neck Service, Department of Surgery, MSKCC.Search for more papers by this authorRonald H. Spiro MD, Ronald H. Spiro MD Psychiatry Service, Memorial Sloan-Kettering Cancer Center, New York City; Dental Service, Department of Surgery, MSKCC; and Head and Neck Service, Department of Surgery, MSKCC.Search for more papers by this authorJimmie C. Holland MD, Jimmie C. Holland MD Psychiatry Service, Memorial Sloan-Kettering Cancer Center, New York City; Dental Service, Department of Surgery, MSKCC; and Head and Neck Service, Department of Surgery, MSKCC.Search for more papers by this author Alice B. Kornblith PhD, Corresponding Author Alice B. Kornblith PhD Psychiatry Service, Memorial Sloan-Kettering Cancer Center, New York City; Dental Service, Department of Surgery, MSKCC; and Head and Neck Service, Department of Surgery, MSKCC.Psychiatry Service, Box 266, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021Search for more papers by this authorIan M. Zlotolow DMD, Ian M. Zlotolow DMD Psychiatry Service, Memorial Sloan-Kettering Cancer Center, New York City; Dental Service, Department of Surgery, MSKCC; and Head and Neck Service, Department of Surgery, MSKCC.Search for more papers by this authorJane Gooen MA, Jane Gooen MA Psychiatry Service, Memorial Sloan-Kettering Cancer Center, New York City; Dental Service, Department of Surgery, MSKCC; and Head and Neck Service, Department of Surgery, MSKCC.Search for more papers by this authorJoseph M. Huryn DDS, Joseph M. Huryn DDS Psychiatry Service, Memorial Sloan-Kettering Cancer Center, New York City; Dental Service, Department of Surgery, MSKCC; and Head and Neck Service, Department of Surgery, MSKCC.Search for more papers by this authorTodd Lerner DDS, Todd Lerner DDS Psychiatry Service, Memorial Sloan-Kettering Cancer Center, New York City; Dental Service, Department of Surgery, MSKCC; and Head and Neck Service, Department of Surgery, MSKCC.Search for more papers by this authorElliot W. Strong MD, Elliot W. Strong MD Psychiatry Service, Memorial Sloan-Kettering Cancer Center, New York City; Dental Service, Department of Surgery, MSKCC; and Head and Neck Service, Department of Surgery, MSKCC.Search for more papers by this authorJatin P. Shah MD, Jatin P. Shah MD Psychiatry Service, Memorial Sloan-Kettering Cancer Center, New York City; Dental Service, Department of Surgery, MSKCC; and Head and Neck Service, Department of Surgery, MSKCC.Search for more papers by this authorRonald H. Spiro MD, Ronald H. Spiro MD Psychiatry Service, Memorial Sloan-Kettering Cancer Center, New York City; Dental Service, Department of Surgery, MSKCC; and Head and Neck Service, Department of Surgery, MSKCC.Search for more papers by this authorJimmie C. Holland MD, Jimmie C. Holland MD Psychiatry Service, Memorial Sloan-Kettering Cancer Center, New York City; Dental Service, Department of Surgery, MSKCC; and Head and Neck Service, Department of Surgery, MSKCC.Search for more papers by this author First published: July/August 1996 https://doi.org/10.1002/(SICI)1097-0347(199607/08)18:4 3.0.CO;2-%23Citations: 163AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat Abstract Background The psychosocial adaptation of patients who had undergone a resection of the maxilla for cancer of the maxillary antrum and/or hard palate with the placement of an obturator prosthesis to restore speech and eating function was studied. Methods Forty-seven patients were interviewed who had a maxillectomy with an obturator prosthesis at Memorial Sloan-Kettering Cancer Center, an average of 5.2 years (SD = 2.4 years) ago, 94% of whom had some of their soft palate resected. Interviews were conducted by telephone by a trained research interviewer, using a series of questionnaires to assess their satisfaction with the functioning of their obturator, and the psychological, vocational, family, social, and sexual adjustment. Measures included the Obturator Functioning Scale (OFS), Psychosocial Adjustment to Illness Scale (PAIS), Mental Health Inventory (MHI), Impact of Event Scale, and Family Functioning Scale. Results Using multiple regression and discriminant function analyses, satisfactory functioning of the obturator prosthesis, as measured by the OFS, was found to be (1) the most highly significant predictor of adjustment, as measured by the PAIS (p < .0001) and the MHI Global Psychological Distress Subscale (MHI-GPD) (p < .001), and (2) significantly related to their perception of the negative socioeconomic impact of cancer upon their lives. The most significant predictors of better obturator functioning were the extent of resection of their soft palate (one third or less, p < .001), and hard palate (one fourth or less, p < .01). Specific aspects of obturator functioning that most significantly correlated with better adjustment (PAIS, MHI-GPD) were: less difficulty in pronouncing words (r = .40 and r = .51, respectively, p < .01), chewing and swallowing food (r = .27–.46, p < .05), and less change in their voice quality after surgery (r = .52 and r = .56, respectively, p < .001). Conclusions These findings suggest that a well-functioning obturator significantly contributes to improving the quality of life of maxillectomy patients. HEAD & NECK 1996;18:323–334 © 1996 John Wiley & Sons, Inc. References 1 Beumer J, Zlotolow I, Curtis TA. Rehabilitation. In: S Silverman, ed. Oral cancer, 3rd ed. Atlanta: American Cancer Society, 1990: 127–148. Google Scholar 2 Huryn JM, Piro JD. The maxillary immediate surgical obturator prosthesis. J Prosthet Dent 1989; 61: 343–347. 10.1016/0022-3913(89)90142-X CASPubMedWeb of Science®Google Scholar 3 Rozen RD, Ordway DE, Curtis TA, Cantor R. 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