Surgical facial reconstruction choices can make a difference in a patient’s quality of life.

When a patient is choosing between a permanent or prosthetic solution for a palatal defect, such as an orinasal fistula, results of a recent study showed that those with reconstruction surgery had higher quality of life scores.

Functional outcomes were determined by comparing two groups of patients: those who were rehabilitated with a prosthetic obturator (a prosthesis that occludes an opening in the roof of the mouth, similar to a dental retainer but without the front wire) and those who had palatomaxillary reconstruction.

The ability to perform simple tasks such as drinking a glass of water or carrying on an intelligible conversation were often impossible with an obturator. However the group who underwent reconstruction surgery achieved higher mastication and speech assessment scores.

There are other mitigating factors that make the prosthetic less appealing. Some palatomaxillary defects can’t be suitably addressed with an obturator. Also, patients who have severe trimus caused by prior therapy will be challenged to use a bulky obturator.

The decision to perform primary reconstruction revolves around the size of the palatal defect, the number, condition and distribution of the teeth, the availability of the alveolar bone to allow dental implant placement and any prior radiation treatment that has been performed.

When possible, undergoing reconstruction can be an option that patients will want to consider to regain long-term quality of life.

Thyroid cancer is the fastest growing cancer in the United States.

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The American Society of Clinical Oncology estimates that 56,460 adults in the United States (13,250 men and 43,210 women) will be diagnosed with thyroid cancer this year. It is currently the fastest-growing cancer in America. How much is due to an increase in surveillance or screenings and how much is due to a biological change in disease prevalence is uncertain. The lack of symptoms also means that, in some cases, the disease progresses to advanced stages before people are aware they have a thyroid problem. Read More

Controversies in thyroid cancer management.

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Not everyone agrees with the clinical decisions that are made in the management of thyroid cancer. The extent of surgery and the use of postoperative radioactive iodine (thyroid remnant ablation) remain quite controversial. The importance of prophylactic removal of lymph nodes is also frequently debated at national and local meetings. Read More

Restoring facial appearance with oromandibular reconstruction can return a patient to function.

It’s more than making someone “look normal” again, although that is a primary concern after a person has been through the resection of a tumor in the facial region. Restoration of the mandibular contour and motion is critical to allow for normal chewing. Restoring sensation in the lips and soft tissue and dentition can also be part of the process, depending on the particular needs of the patient. Read More