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Pain, function, and psychologic outcome before, during, and after intraoral tumor resection
Nils-Clauidus Gellrich1, Ronald Schimming, Alexander Schramm
1Department of Oral and Maxillofacial Surgery, University of Freiburg, Hugstetterstrasse 55, D-79106 Freiburg, Germany. gellrich@zmk2.ukl.uni-freiburg.de
Purpose:
The aim of the present study was to determine the quality of life of patients with respect to pain before, during, and after ablative intraoral tumor surgery.
Patients And Methods:
The Bochum Questionnaire on Rehabilitation was used to determine 147 items including the morphologic, functional, and psychosocial aspects of rehabilitation. One thousand six hundred fifty-two of 3,500 patients (47.2%) (413 women and 1,239 men) completed the questionnaire. The statistical investigation was carried out using 2-sample (independent) and paired (dependent) t tests.
Results:
Pain and the functional impairment of chewing and swallowing are the most important parameters before treatment. Immediately after surgical treatment, other variables, such as speech intelligibility and mobility disorders in the head, neck, and shoulder regions, became more apparent. Pain was reported in the shoulder region in 38.5% and in the neck in 34.9% of patients after surgery. The temporomandibular joint was painful in 20.1%, the oral cavity in 18.7%, and the face in 8.2%. Pain was described by 7.4% of patients in other regions of the head. Seventy-five percent of 1527 patients were not taking pain medications during the investigation. The rate of physiotherapy consequently applied after surgery was less than 10%.
Conclusions:
Quality of life after ablative intraoral surgery is not greatly affected by pain. Because functional disorders play the dominant role in the impairment of postoperative quality of life, functional reconstruction, using microvascular techniques, and early rehabilitation, including physiotherapy, should be intensified.