[Clinical nutrition in maxillofacial cancer surgery. A review of the literature]

The authors review the literature on problems of nutrition in patients with operable maxillofacial neoplasms. The causes of malnutrition in head-neck tumours will be particularly examined: metabolic alteration due to the presence of neoplasm; the tumour being situated in the first upper respiratory-digestive tracts; the side effects of chemotherapy and/or radiotherapy; the results of surgery and finally those of a late diagnosis. Once clinical nutrition has been indicated by both clinical and biochemical parameters, a plan for the most frequently used pre- postoperative treatments is drawn up. Reviewing the literature disagreement is found as the most effective method--enteral or parenteral--given that both solutions present advantages and disadvantages. The former is more physiological less expensive and simpler to carry out while the latter permits a more individualised form of treatment and the metabolic evaluation is simplified. The authors will go to present their own treatment plans: parenteral in the preoperative phase and in the postoperative patient a gradual weaning from parenteral to enteral treatment. The most important lines in both enteral and parenteral feeding are examined and the authors conclude by confirming that artificial nutritional therapy makes absolutely no difference to the prognosis but allows the patient to undergo the appropriate therapy.