Effect of obturators on facial form following surgery for head and neck cancer and impact on the perception of appearance

Objectives: To describe the correlation between changes in the surface area and depth of the face in individuals wearing an obturator compared with it not being in place, and self-reported Quality of Life in relation to appearance. Methods: Difference images were created from stereophotogrammetry images recorded from research participants with and without their obturators in place. On the difference images of the face, surface areas and mean depths were calculated. Oral health impact profile questionnaires (OHIP-49) were completed. Results: Data from 19 research participants were recorded. The mean size of the outlined area of the face when the obturators were present compared to when they were not was 1411 mm(2) (SD +/- 848). Similarly the mean depth differences ranged up to 6.14 mm. Although a proportion of the individuals reported effects in relation to their quality of life, there were no statistically significant relations between the surface areas and mean depths with the participants' responses to the quality of life questions. Conclusions: There are clear changes in facial tissues, both in relation to surface area and depths when obturators are worn compared to when they are not. There is no simple relationship between the extent of facial change with and without an obturator and quality of life around appearance. The determinants of changed quality of life in this group of patients require greater exploration.