Lee Evelyn G L, Ryan Fiona S, Shute Justin, Cunningham Susan J
Department of Orthodontics, University College London, Eastman Dental Institute, London, England.
J Oral Maxillofac Surg. 2011 Nov;69(11):e431-45. doi: 10.1016/j.joms.2011.07.013.
Inferior dental nerve paresthesia is a well-known risk of orthognathic surgery, but little is known about the effects of altered sensation in day-to-day life. Therefore the aim of this study was to assess the impact of altered sensation after orthognathic treatment.
The study was divided into 2 parts: the first phase involved semistructured, in-depth interviews with 13 post-treatment orthognathic patients who presented with altered sensation affecting the lower lip. In the second part of the study, the data from the interviews were used to develop a questionnaire that was distributed to 40 post-orthognathic patients (75% completion [n = 30]). The results were analyzed by use of descriptive statistical methods.
In both stages of the study, common descriptors used to describe the altered sensation were "tingling" and "numb." The majority of patients were aware of the neurosensory disturbance when touching their lips, face, or jaw, and patients also expressed difficulties knowing when food was left on their lip. It was noted that patients who were aware of the altered sensation all of the time expressed the greatest distress in their everyday life. When it came to emotions associated with the altered sensation, the majority of patients were disappointed, but few were upset or angry.
The impact of altered sensation due to inferior dental nerve damage after orthognathic surgery varied from patient to patient, but altered sensation had a significant effect on the majority of patients' everyday lives. The information obtained from this study makes an important contribution to the informed consent process.
下牙槽神经感觉异常是正颌外科手术一种众所周知的风险,但对于日常生活中感觉改变的影响却知之甚少。因此,本研究的目的是评估正颌治疗后感觉改变的影响。
本研究分为两部分:第一阶段对13例治疗后出现下唇感觉改变的正颌患者进行半结构化深入访谈。在研究的第二部分,访谈数据用于编制一份问卷,并分发给40例正颌术后患者(完成率75%[n = 30])。采用描述性统计方法分析结果。
在研究的两个阶段,用于描述感觉改变的常见描述词是“刺痛”和“麻木”。大多数患者在触摸嘴唇、面部或下颌时能意识到神经感觉障碍,患者还表示难以知道食物是否残留在嘴唇上。值得注意的是,一直意识到感觉改变的患者在日常生活中表现出最大的困扰。在与感觉改变相关的情绪方面,大多数患者感到失望,但很少有人心烦或生气。
正颌手术后下牙槽神经损伤导致的感觉改变对不同患者的影响各不相同,但感觉改变对大多数患者的日常生活有显著影响。本研究获得的信息对知情同意过程有重要贡献。