Functional Rehabilitation After Jaw Resection for Malignancy: A Prospective Assessment of Prosthetic and Surgical Reconstruction Approaches in South East Nigeria

Jaw resection for primary malignancies including squamous cell carcinoma, osteosarcoma, and ameloblastic carcinoma results in significant functional deficits encompassing mastication, speech, swallowing, and facial aesthetics. The rehabilitation strategy, whether prosthetic obturation or surgical reconstruction using bone grafts or flaps, profoundly influences patient functional recovery. This prospective comparative study assesses functional rehabilitation outcomes following jaw resection for malignancy using prosthetic versus surgical reconstruction approaches at the University of Nigeria Teaching Hospital Enugu and Enugu State University Teaching Hospital, South East Nigeria, over a five-year period from 2019 to 2023. Forty-six patients underwent jaw resection for confirmed malignancy; 24 received surgical reconstruction and 22 were rehabilitated with prosthetic obturation. Functional outcomes were measured at baseline, 6 months, and 12 months using validated instruments including the MDADI for swallowing, the Liverpool Oral Rehabilitation Questionnaire (LORQuest), and standardized speech intelligibility assessment. Results indicate superior mastication and speech intelligibility scores in the surgical reconstruction group at 12 months, though prosthetic rehabilitation achieved acceptable social function outcomes at lower cost. Patient preference, tumor margin status, and availability of reconstructive expertise significantly influenced rehabilitation approach selection. The study provides comparative outcome data specific to the South East Nigerian context and recommends the development of multidisciplinary jaw rehabilitation pathways at regional cancer referral centers. Keywords: jaw resection, malignancy, functional rehabilitation, prosthetic obturation, surgical reconstruction.