Impact of CAD/CAM mandibular reconstruction on chewing and swallowing function after surgery for locally advanced oral cancer: A retrospective study of 50 cases

Auris Nasus Larynx. 2021 Oct;48(5):1007-1012. doi: 10.1016/j.anl.2021.03.014. Epub 2021 Apr 3.

Abstract

Objective: Computer-aided design and computer-aided manufacturing (CAD/CAM) techniques are increasingly applied to mandibular reconstruction, but the superiority of this method in oral food intake has not been well established. Considering the extent of mandibular defects, this retrospective study was aimed to clarify the impact of CAD/CAM mandibular reconstruction on chewing and swallowing function after surgery for locally advanced oral cancer.

Materials and methods: We performed a retrospective review of 50 patients who had undergone segmental mandibulectomy with free flap reconstruction for locally advanced oral cancer. The patients' Functional Oral Intake Scale scores were measured at 3 months after surgery, and possible contributing factors including CAD/CAM mandibular reconstruction and the extent of mandibular defects for oral food intake were subjected to univariate analysis and multivariate logistic regression analysis.

Results: Multivariate logistic regression analysis showed that CAD/CAM mandibular reconstruction was independently associated with good oral intake, whereas both anterior or extensive mandibular resection and glossectomy were also independently associated with poor oral intake after surgery.

Conclusion: The present study showed the positive impact of CAD/CAM mandibular reconstruction on chewing and swallowing function after surgery for locally advanced oral cancer for the first time.

Keywords: CAD/CAM; Oral cancer; Segmental mandibulectomy.

MeSH terms

  • Aged
  • Bone Transplantation / methods*
  • Computer-Aided Design*
  • Deglutition / physiology
  • Eating
  • Female
  • Fibula / transplantation*
  • Free Tissue Flaps
  • Humans
  • Imaging, Three-Dimensional
  • Logistic Models
  • Male
  • Mandibular Osteotomy / methods*
  • Mandibular Reconstruction / methods*
  • Mastication / physiology
  • Mouth Neoplasms / pathology
  • Mouth Neoplasms / surgery*
  • Multivariate Analysis
  • Postoperative Complications / epidemiology*
  • Retrospective Studies
  • Scapula / transplantation
  • Squamous Cell Carcinoma of Head and Neck / surgery*