A systematic review of validated tools assessing functional and aesthetic outcomes following fibula free flap reconstruction of the mandible

Background Segmental mandibulectomy impairs health‐related quality of life (QoL), by altering speech, mastication, swallowing, and facial aesthetics. Fibula free flap (FFF) used for mandible reconstruction is known to improve outcomes; however, minimal information exists in the literature regarding patient‐reported outcomes. We aim to assess how current studies evaluate patient perception following segmental mandibulectomy and FFF mandible reconstruction. Methods Following Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines, a search was conducted for publications involving FFF mandible reconstruction from 2005 to 2017 using PubMed, Cochrane, EMBASE, Web of Science, and PsychInfo. Results Of 2212 articles identified initially, only 7 studies were deemed suitable. Six studies used the University of Washington Quality of Life questionnaire, 3 Oral Health Impact Profile, and 1 used European Organization for Research and Treatment of Cancer Head and Neck (EORTC‐H&N35). Conclusions There is a paucity of information in published reports on QoL outcomes following mandible reconstruction with FFF. In the era of patient‐centered health care, observations warrant attention from researchers for physician‐assessed patient‐reported measures to factor in QoL expectation during surgical decision‐making about the choice of reconstruction.