Quality of Life

Introduction

Quality of Life (QoL) can be defined as the “perceived discrepancy between the reality of what a person has and the concept of what the person wants, needs, or expects.” QoL is multidimensional, incorporating physical, psychological, social, emotional, and functional domains. It is subjective and must be based on self-reporting according to a patient's own experiences. Thus, data from QoL questionnaires are becoming an important supplement to information pertaining to treatment outcome.

Quality of Life Outcomes From Surgery

Differences between surgery for benign versus malignant disease were found to be significant in a QoL study on parotidectomy. Regarding QoL and surgery, Beutner et al. reported no alterations in QoL 1 year after lateral or superficial parotidectomy. Fang et al. evaluated long-term QoL in child survivors of parotid tumor surgery and found that it had a limited negative impact. Breeze et al. prospectively studied QoL after treatment of cancer of the submandibular gland. QoL dropped at 6 months, but had resolved to >80% of the pretreatment value by a year, with the exception of the domains taste and saliva. Becker et al. concluded that “appearance”, “activity” and “anxiety” are the domains with the lowest scores. Radiation therapy has the highest impact on health-related QoL and seems to be the most substantial negative factor.

Reported QoL issues associated with the submandibular glands include drooling and relocation of the ducts. Min et al. studied the option of partial submandibular gland excision rather than removal of the whole gland in two patient groups. The extent of injury to the lingual nerve, together with deformities of the facial contour were significantly less in the group in which the gland was preserved. Postoperative salivary production and overall patients’ satisfaction were also better in that group. They recommend that gland-preserving techniques be deployed where feasible for management of benign submandibular tumors.

Hirota et al. found the youngest among all patients reported a significantly greater worsening of their physical well-being and emotional status after treatment as compared with others. Age of development of the neoplasm and type of disease had a greater effect on QoL than treatment modality. Al-Mamgani et al. reported parotid surgery and postoperative radiotherapy resulted in excellent outcomes with minimal side effects and preservation of good QoL scores.