Maxillectomy and Quality of Life: Experience from a Nigerian Tertiary Institution.

Abstract

Introduction: Maxillectomy is a surgical procedure for managing tumors affecting the maxilla; the goal of maxillectomy however should not be limited to tumor extirpation but should include restoration of oronasal function and facial contours, as failure to do these may give rise to psychosocial and functional challenges. This study aimed to appraise the pattern of maxillectomies, challenges of management, and quality of life (QOL) of a proportion of the study population.

Materials and methods: This was a cross-sectional study carried out at the Department of Oral and Maxillofacial Surgery, University College Hospital, Ibadan. Patients' case files from year 2000 to 2016 were retrieved and reviewed. Data extracted for analysis included age, gender, site of lesion, and histologic diagnosis; lesions were grouped as benign or malignant. Contacts were made with patients or their next of kin for a clinic review appointment where QOL was assessed with the University of Washington Quality of Life version 4 Questionnaire. Data were analyzed and result presented as means and frequencies.

Results: Out of the 78 cases of maxillectomy recorded in the department within the study period, records were available and adequate in 67 cases. There were 37 (55.2%) females with a mean age of 35.88 ± 14.9 years. Swelling was the most common reason for presentation (63, 94%). The mean period between onset of disease and presentation for treatment was 3.66 ± 3.35 years. Distribution of lesions was benign 35 (52.2%) and malignant 32 (47.8%). Hemi-maxillectomy was the commonest surgical procedure (23, 34.8%). While majority had some prosthetic rehabilitation, 31 participants (48.5%) obtained no prosthesis. Eight participants gave scores of ≥75% when comparing their present health-related QOL (HR-QOL) with a month before surgery; the overall QOL was ≥60%. However, HR-QOL and overall QOL in the last 7 days before assessment were rated as good in 55.6% and 66.7%, respectively. Chewing was the most important domain to participants.

Conclusion: The pattern of presentation and indications for maxillectomy in this series are similar to that from previous studies. The uptake of prosthetic rehabilitation was low and overall QOL was rated as fair. QOL should be considered as part of treatment outcome measure for maxillectomy.