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Cited by 3Reconstructive Surgery and Microvascular TechniquesReconstructive Facial Surgery TechniquesHead and Neck Cancer Studies

The DOI matches its Crossref record; 28 of the 28 references it cites were found in a registry or an index.

Functional Rehabilitation and Quality of Life After Fibula Free Flap Reconstruction in Mandibular Defects

Fiedler, Mathias, Brunnhuber, Christoph, Eichberger, Jonas, Gottsauner, Maximilian, Schuderer, Johannes G., Maurer, Michael, Taxis, Jürgen, Meier, Johannes K., Gerken, Michael, Reichert, Torsten E., Ettl, Tobias·2026·Journal of Reconstructive Microsurgery
DOI 10.1055/a-2687-0316
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Abstract

Patients undergoing mandibular reconstruction often experience long-term functional and aesthetic challenges, impacting their quality of life (QOL). The objective of this study was to identify factors that most powerfully impact the long-term QOL and functional outcome of patients following mandibular reconstruction with free fibula flaps. This investigation was undertaken to enhance the treatment of this patient population. QOL was assessed between March 2022 and May 2023 in 47 consecutive patients undergoing mandibular reconstruction with fibula free flaps (FFFs) using the University of Washington QOL Questionnaire. Evaluation of functional outcome was based on mouth opening, jaw deviation, tissue atrophy, tongue mobility, lip competence, and speech intelligibility. The study found that loss of chewing was the strongest impairment of QOL (score: 63.83). The most important negative predictors for QOL were female gender (p = 0.047), radiotherapy (QOL subcategory p-values: p = 0.007 to p = 0.034), anterior segment resection (QOL subcategory p-values: p = 0.038 to p = 0.045), advanced defect size (QOL subcategory p-values: p = 0.008 to p = 0.035), and free-hand fibula reconstruction (QOL subcategory p-values: p = 0.003 to p = 0.041). Long-term outcomes revealed that reduced tissue atrophy (QOL subcategory p-values: p < 0.001 to p = 0.025) and preserved tongue mobility (QOL subcategory p-values: p = 0.002 to p = 0.043) were associated with better QOL scores. Functional limitations such as reduced mouth opening (QOL subcategory p-values: p = 0.008 to p = 0.049) and impaired speech intelligibility (QOL subcategory p-values: p < 0.001 to p = 0.015) were significantly correlated with lower QOL in several domains. Mandibular reconstruction with FFFs provides a favorable long-term QOL and functional outcomes, though certain clinical factors, including radiotherapy, anterior segment resection, and defect size, significantly reduce patient-reported QOL.

Overview

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Crossref · 10.1055/a-2687-0316

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Metadata

Authors
Fiedler, M., Brunnhuber, C., Eichberger, J., Gottsauner, M., Schuderer, J. G., Maurer, M., Taxis, J., Meier, J. K., Gerken, M., Reichert, T. E., & Ettl, T.
Affiliations
  • University Hospital Regensburg (DE)
  • Department of Oral and Maxillofacial Surgery, University Hospital Regensburg, Regensburg, Germany
  • University of Regensburg (DE)
ORCID
Venue
Journal of Reconstructive Microsurgery
Publisher
Georg Thieme Verlag KG
Published
2025-08-21
Volume
42
Issue
06
Pages
482-490
ISSN
  • 0743-684X (ISSN-L)
  • 1098-8947
DOI
10.1055/a-2687-0316
OpenAlex
W4413385670
Cited by
2
References
28
Citations by year
2026: 2
FWCI
1.90
Type
journal article
Language
en
Open access
closed
Locations
  • Journal of Reconstructive Microsurgery (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Reconstructive Surgery and Microvascular Techniques
  • Health Sciences › Medicine › Surgery › Reconstructive Facial Surgery Techniques
  • Health Sciences › Medicine › Otorhinolaryngology › Head and Neck Cancer Studies
Keywords
mandibular reconstruction, fibula free flap, quality of life, functional outcome, mandibular defects, mouth opening, radiotherapy, defect size, tissue atrophy, tongue mobility, speech intelligibility, prognostic factors
MeSH terms
Adult, Aged, Female, Fibula, Humans, Male, Mandible, Middle Aged, Quality of Life, Surveys and Questionnaires, Speech Intelligibility, Treatment Outcome, Free Tissue Flaps, Mandibular Reconstruction

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