Royapettah Scoring System - A Functional Assessment of Oral Cancer Resection.

Ramesh, M (2006) Royapettah Scoring System - A Functional Assessment of Oral Cancer Resection. Masters thesis, Kilpauk Medical College, Chennai.


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INTRODUCTION : Head and Neck cancer is one of the most common cancers in our country and Oral cavity is the commonest site among these cancers constituting 30 % of the total. Nearly half of the patients are in locoregionally advanced stage at the time of presentation. This same trend prevails in our hospital also. Mortality in Head & Neck cancers is mostly due to uncontrolled locoregional disease. Therefore control of locoregional disease becomes the cornerstone of treatment in such patients which involves multimodal approach in the form of Surgery and Radiotherapy. Surgery often has to be extensive in nature with Radiotherapy added preoperatively most of the time. This extensive resection needs complex reconstructive procedures. Hence the resultant morbidity is not only from the disease itself but also significantly from the consequences of these aggressive treatments. Head and Neck region, the most important part of the body cosmetically, is also the sheet anchor of important basic functions of life like chewing, swallowing and speech. Surgery often results in acceptable to devastating morbidities in terms of function and cosmesis. The affected functions are mouth opening, oral competence, occlusion, speech and swallowing. The role of oncological care does not stop with surgery alone but involves the effective rehabilitation of these functional problems thereby improving the quality of life. Nowadays the outcome of treatment is not only assessed with over all survival and Disease Free interval but also with assessment of Quality of life (QOL) following treatment. Hence outcome of treatment of oral cancer with good survival but without acceptable functional outcome is meaningless. Our patients belong largely to low socio economic group with poor intelligence and come from places which are far away. With this background we devised this simple scoring system based on clinical methods to assess the functional outcome which can be applied in the outpatient department itself. AIMS : To evolve a simple assessment system for assessing the functional outcome of oral cancer resection based on clinical methods which can be applied at the Outpatient department itself To assess the psychosocial impact of the Morbidity. To assess the correlation of functional impairment to the type and extent of resection. To assess how the patient adapts to the impairment over the period of time. To assess the priority of Rehabilitation needs. To assess the reconstructive efficacy of our surgery. and ultimately assessing the over all quality of life following Surgery and how this scoring system is useful in our setup and our set of patients. CONCLUSION : The criteria we have laid down for the extent of impairment is simple and clear to follow with minimal bias between the observers. Patient compliance is also very good for this assessment. Merits of the System : Simple, Easy Applicability, Quick Assessment, Done at the Outpatient Department itself, No investigations and Good patient compliance. Therefore our Royapettah Scoring system is a simple clinical and cost effective method. It gives an effective assessment of functional outcome in our series of patients and we plan rehabilitation therapy based on that and found it very useful to our patients.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Royapettah Scoring System ; Functional Assessment ; Oral Cancer Resection.
Subjects: MEDICAL > Surgical Oncology
Depositing User: Kambaraman B
Date Deposited: 25 Jul 2017 02:58
Last Modified: 25 Jul 2017 02:58

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