Support Group - Research
Jan Jennings, Leo H-H Cheng
Most treatment for patients with oro-facial cancer affects the aesthetic or functional outcome. It is well known that quality of life scores are worse after treatment. Hence it is often perceived that the unpleasant and undesirable side effects of treatment led to a high level of patient dissatisfaction. In order to investigate this, and to determine the level of satisfaction following treatment, this retrospective study was undertaken.
All 85 patients with oro-facial cancer seen in the multidisciplinary Head and Neck Oncology Clinic (between 2000 and 2002) who had undergone either surgery, radiotherapy or both were sent a postal questionnaire. The subjects, all at least 1 month after treatment, were asked whether the treatment had improved or worsened their general facial appearance and oro-facial function and they responded on appropriate visual analogue scales (-10 to +10, Diagram 1).
65 out of 68 living patients responded making a 96% response rate (Diagram 2). 52% of patients treated had tongue cancer (Diagram 3). The level of satisfaction for both appearance (mean score of +1.82) and function (mean score of 0.56) was positive except for the function of eating and chewing (Diagram 4). 38 (58%) patients found improvement or no change to their appearance and oro-facial function (Diagram 5).
Despite the inevitable suffering and undesirable side effects of cancer treatment, our local survey showed reasonable levels of satisfaction after treatment. This survey highlighted the patient's perception could be different from the clinicians' expectation.
We would like to thank all patients and carers for their contribution to this survey and the About Face Patients and Carers Support Group
Leo H-H Cheng
Thorough debridement is essential for the management of contaminated facial and conjunctival wounds in order to prevent permanent tattooing of facial scars and secondary facial aesthetic surgery. For complex contaminated wounds with underlying bony injury, incomplete debridement will increase the risk of wound infection and dehiscence, and compromise access for secondary surgery. Ultrasonic debridement has been well described in periodontology, endodontics, and in the treatment of mitral calcification, burns and contaminated bone. We have therefore investigated the feasibility of using the Piezon Master 400 ultrasonic scaler (Piezon, Switzerland) for the debridement of contaminated facial soft tissue and conjunctival wounds.
Of the 40 patients with contaminated facial wounds, 1 had conjunctival wounds, 10 had underlying maxillofacial and 3 had cranial skeletal fractures. Open facial wounds were closed primarily with no loss of adjacent viable soft tissues. No patient had tattooed scarring or a neurological deficit.
Our preliminary study shows that ultrasonic debridement provides efficient, rapid, precise and thorough removal of ingrained dirt and grit from contaminated facial and conjunctival wounds with minimal iatrogenic damage to adjacent normal skin or conjunctiva.
|© OMFSAboutFace 2009|