Dimitroulis George, McCullough Michael, Morrison Wayne
Department of Surgery, St Vincent's Hospital, University of Melbourne, Melbourne, Australia.
J Oral Maxillofac Surg. 2010 Jan;68(1):101-6. doi: 10.1016/j.joms.2009.07.092.
The aim of this study was to assess the quality-of-life (QoL) outcomes of patients who had undergone temporomandibular joint (TMJ) discectomy with dermis-fat grafting compared with a cohort of closely matched patients who had not had surgery.
A cross-sectional study of 61 patients was undertaken. All patients completed a TMJ surgery-specific QoL questionnaire. They were divided into 2 groups according to whether they had undergone TMJ discectomy (postsurgical group, n = 32) or not (presurgical group, n = 29). The 2 groups were closely matched for age, gender, clinical presentation, and radiologic diagnoses of Wilkes stage IV TMJ internal derangement.
Post-TMJ surgery patients showed statistically significant decreases in pain levels (P < .05), diet and chewing (P < .01), mood (P < .01), anxiety (P < .01), and general health (P < .05) compared with the presurgical patients. However, there were no statistically significant differences between the pre- and post-TMJ surgery groups in terms of speech, level of activity, recreation, and general well-being.
The results of this study suggest that TMJ discectomy with dermis-fat grafting appears to have a positive QoL effect in terms of reducing pain levels and improving diet and chewing, mood, anxiety, and general health in patients with Wilkes stage IV TMJ internal derangement.
本研究旨在评估与一组未接受手术的匹配患者相比,接受颞下颌关节(TMJ)椎间盘切除术并植入真皮脂肪移植的患者的生活质量(QoL)结果。
对61例患者进行了横断面研究。所有患者均完成了一份针对TMJ手术的QoL问卷。根据是否接受TMJ椎间盘切除术,将他们分为两组(术后组,n = 32;术前组,n = 29)。两组在年龄、性别、临床表现和Wilkes IV期TMJ内紊乱的放射学诊断方面进行了密切匹配。
与术前患者相比,TMJ手术后患者的疼痛水平(P <.05)、饮食和咀嚼(P <.01)、情绪(P <.01)、焦虑(P <.01)和总体健康状况(P <.05)有统计学意义的下降。然而,TMJ手术前后两组在言语、活动水平、娱乐和总体幸福感方面没有统计学意义的差异。
本研究结果表明,对于Wilkes IV期TMJ内紊乱患者,TMJ椎间盘切除术并植入真皮脂肪移植在降低疼痛水平、改善饮食和咀嚼、情绪、焦虑和总体健康方面似乎对生活质量有积极影响。