Assessing Patient-Reported Outcomes: A Mixed Methods Qualitative Comparison Between Obturator and Surgically...

Area of Science:

• Head and Neck Surgery
• Reconstructive Surgery
• Oncology Rehabilitation

Background:

• Maxillectomy for head and neck cancers necessitates rehabilitation.
• Surgical reconstruction and obturator insertion are common post-maxillectomy options.
• Lack of consensus exists on choosing between reconstruction and obturators.

Purpose of the Study:

• To identify unique functional domains for patients undergoing maxillectomy.
• To differentiate functional outcomes between surgical reconstruction and obturator insertion.
• To provide data for standardized selection of post-maxillectomy rehabilitation.

Main Methods:

• Mixed-methods qualitative research using grounded theory interviews and Delphi technique focus groups.
• Conducted at a tertiary care center from January 2020 to June 2022.
• Included adult patients (18+) who had maxillectomy for head and neck cancer.

Main Results:

• Common domains affecting all patients: eating/speaking difficulties, social discomfort, numbness.
• Unique domains for surgical reconstruction: dry mouth, trismus, chewing issues, eye symptoms.
• Unique domains for obturator use: obturator discomfort, nasal regurgitation, weight loss, voice changes.

Conclusions:

• Identified specific functional domains to guide rehabilitation method selection post-maxillectomy.
• Findings can inform clinical practice for better patient-centered care.
• Data may facilitate development of a patient-reported outcomes instrument for this population.